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. Which of the following is an example of a sentinel event in healthcare?

• A. A patient falling in the hospital without injury
• B. A near-miss medication error
• C. An unexpected patient death unrelated to the natural course of illness
• D. A patient developing an infection during a hospital stay

Correct answer: C

Rationale: The correct answer is C. A sentinel event in healthcare is an unexpected patient death unrelated to the natural course of illness. These events are serious occurrences that warrant immediate investigation and response to prevent their recurrence and ensure patient safety. Choices A, B, and D do not fit the definition of a sentinel event. While choices A, B, and D are serious incidents, they do not involve an unexpected patient death unrelated to the natural course of illness, which is the defining characteristic of a sentinel event.

3. Which of the following is a characteristic of a well-written goal?

• A. Goals should be vague
• B. Goals should be unrealistic
• C. Goals need to be measurable, realistic, and achievable
• D. Goals should be easy to achieve

Correct answer: C

Rationale: The correct answer is C: Goals need to be measurable, realistic, and achievable. Well-written goals should be specific and quantifiable to provide clear direction and motivation. Choice A is incorrect as goals should not be vague but rather specific. Choice B is incorrect as goals should be realistic to be attainable. Choice D is incorrect as goals should challenge individuals and not be too easy to achieve to promote growth and development.

4. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

• A. The patient always carries hard candies when engaging in exercise.
• B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
• C. The patient has a peanut butter sandwich before going for a bicycle ride.
• D. The patient increases daily exercise when ketones are present in the urine.

Correct answer: D

Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

5. A __________ is often helpful to use when a problem is not easily identified.

• A. trial and error
• B. Delphi method
• C. political decision-making model
• D. affinity map

Correct answer: D

Rationale: An affinity map is a tool commonly used when a problem is not easily identified. It helps in organizing and grouping ideas, data, or information based on relationships or themes. Choice A, 'trial and error,' involves repeatedly trying different solutions until the problem is solved, which may not be efficient when the problem is not clearly defined. Choice B, the 'Delphi method,' is a structured communication technique for experts to reach a consensus, not specifically for unidentified problems. Choice C, 'political decision-making model,' refers to a process for making decisions in political contexts and is not directly related to identifying unknown problems.

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