Nursing Elites

1. A healthcare worker is caring for a group of clients in an infectious disease unit. The worker should wear an OSHA-approved N95 respirator mask when caring for a client with which of the following infectious diseases?

• A. Pertussis
• B. Mycoplasma pneumonia
• C. Tuberculosis
• D. Respiratory syncytial virus

Correct answer: C

Rationale: An OSHA-approved N95 respirator mask is recommended when caring for a client with tuberculosis due to the airborne transmission of the disease. Tuberculosis poses a higher risk of transmission via respiratory droplets, making respiratory protection essential to prevent exposure and infection among healthcare workers.

2. A client develops a pulmonary embolism. Which of the following interventions should the nurse implement first?

• A. Give morphine IV.
• B. Administer oxygen therapy.
• C. Start an IV infusion of lactated Ringer's.
• D. Initiate cardiac monitoring.

Correct answer: B

Rationale: Administering oxygen therapy is the priority intervention for a client with a pulmonary embolism. Oxygen helps improve oxygenation levels and decrease the workload on the heart. It is crucial to ensure adequate oxygenation before other interventions are initiated. Morphine IV, starting an IV infusion of lactated Ringer's, and initiating cardiac monitoring are important interventions but come after ensuring adequate oxygenation.

3. A nurse is assessing a client with a history of seizures. Which assessment finding requires immediate intervention?

• A. The client is experiencing an aura.
• B. The client's antiseizure medication level is within the therapeutic range.
• C. The client has been seizure-free for 2 years.
• D. The client's seizure activity lasts longer than 5 minutes.

Correct answer: D

Rationale: Seizure activity lasting longer than 5 minutes requires immediate intervention as it can lead to status epilepticus, a medical emergency.

4. A nurse manager wishes to ensure that the nurses on the unit are practicing at their highest levels of competency. Which areas should the manager assess to determine if the nursing staff demonstrate competency according to the Institute of Medicine (IOM) report Health Professions Education: A Bridge to Quality? (Select ONE that does not apply)

• A. Collaborating with an interdisciplinary team
• B. Implementing evidence-based care
• C. Providing family-focused care
• D. Experimenting on patients

Correct answer: D

Rationale: The Institute of Medicine (IOM) report 'Health Professions Education: A Bridge to Quality' outlines five core competencies that healthcare providers should possess. These competencies include collaborating with an interdisciplinary team, implementing evidence-based care, providing family-focused care, using informatics in practice, and focusing on patient-centered care. Therefore, to ensure that nurses are practicing at their highest levels of competency as per the IOM report, the nurse manager should assess all of these areas.

5. A client with tuberculosis is starting combination drug therapy. Which of the following medications should the nurse NOT plan to administer?

• A. Rifampin
• B. Isoniazid
• C. Acyclovir
• D. Pyrazinamide

Correct answer: C

Rationale: Acyclovir is an antiviral medication used to treat herpes virus infections, not tuberculosis. Rifampin, Isoniazid, and Pyrazinamide are all commonly used in the treatment of tuberculosis. Therefore, the nurse should not plan to administer Acyclovir to a client with tuberculosis.

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