Nursing Elites

1. A nurse is admitting a client who has an abdominal wound with a large amount of purulent drainage. Which of the following types of transmission precautions should the nurse initiate?

• A. Droplet precautions
• B. Protective environment
• C. Airborne precautions
• D. Contact precautions

Correct answer: D

Rationale: The correct answer is D: Contact precautions. Contact precautions are used when there is a risk of transmission of infections through direct or indirect contact. In this scenario, the client has an abdominal wound with purulent drainage, indicating a potential for infection transmission through contact. Droplet precautions (choice A) are used for infections transmitted through respiratory droplets, such as influenza. Protective environment (choice B) is used for immunocompromised clients. Airborne precautions (choice C) are used for infections transmitted through small droplets that remain in the air, like tuberculosis. Therefore, in this case, the nurse should initiate contact precautions to prevent the spread of infection.

2. The length of a coaching session should be no longer than:

• A. 15 minutes.
• B. 60 minutes.
• C. 10 minutes.
• D. 30 minutes.

Correct answer: C

Rationale: The correct answer is C: '10 minutes.' Coaching sessions are recommended to last between 5-10 minutes to ensure they are concise and impactful. Choice A ('15 minutes') is incorrect because it exceeds the recommended duration. Choice B ('60 minutes') is incorrect as it is too long for an effective coaching session, leading to decreased engagement. Choice D ('30 minutes') is also incorrect as it surpasses the optimal time frame for a coaching session.

3. A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?

• A. Wear an N95 respirator when giving direct care to the client.
• B. Place the client in a private room with negative-pressure airflow.
• C. Ensure the client's room has at least six air exchanges per hour.
• D. Ensure the client wears a mask when outside their room if there is construction in the area.

Correct answer: A

Rationale: In a protective environment for a client with an allogeneic stem cell transplant, the nurse needs to wear an N95 respirator when providing direct care to the client. This precaution is essential to protect the client, whose immune system is compromised after the transplant, from exposure to potential pathogens. Placing the client in a private room with negative-pressure airflow (choice B) is more appropriate for clients with airborne infections. Ensuring the client's room has sufficient air exchanges (choice C) is important for maintaining air quality but is not the primary precaution for protecting an immunocompromised client. Making the client wear a mask when outside the room due to construction (choice D) focuses on external factors and does not directly address the risk of infection during direct care.

4. As part of Magnet Recognition, you are asked to present your evidence-based practice poster at a national conference. The health care facility supports your participation. Where would information about your participation in the conference need to be communicated? (Select all that apply.)

• A. In a communication to all staff nurses to inspire them.
• B. At a conference within the health care facility.
• C. In an email to a friend.
• D. In a presentation with select individuals.

Correct answer: A

Rationale: The correct answer is A. Sharing information about your participation in the conference with all staff nurses is essential to inspire them, promote a culture of evidence-based practice, and encourage professional development. Choice B is incorrect as it refers to a conference within the health care facility, not the national conference. Choice C is incorrect as informing a friend does not align with the professional impact and growth objectives of presenting at a national conference. Choice D is also incorrect as sharing the information with select individuals limits the reach and impact of the achievement.

5. When a client with a terminal diagnosis asks about advance directives, what should the nurse do?

• A. Engage the client and ask why they want to discuss this without their partner present.
• B. Provide information on advance directives and offer brochures.
• C. Advise the client to schedule a discussion with their provider.
• D. Focus on the client's current feelings and postpone planning for a later time.

Correct answer: A

Rationale: Choice A is the correct response as it demonstrates active listening and empathy by engaging the client in a discussion about their concerns regarding advance directives. It also recognizes the importance of involving the client's partner in such discussions, promoting shared decision-making and support. Choices B and C lack the personalized approach needed in this situation and do not address the client's immediate request for information. Choice D is incorrect as it disregards the client's expressed need to discuss advance directives and focuses solely on their current feelings, delaying a crucial conversation.

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