Nursing Elites

1. A woman presents with bruises on her face and back in various stages of healing. She states, 'sometimes he just gets so angry.' Which of the following statements is most appropriate as a response from the nurse?

• A. Do you mean your boyfriend?
• B. Do you mean your boyfriend?
• C. No one will ever hurt you again.
• D. Tell me more about what happens when he gets angry.

Correct answer: D

Rationale: The most appropriate response from the nurse is to gather more information by asking the client to elaborate on what occurs when the individual in question gets angry. It is essential for the nurse to understand the situation better before taking any action or making assumptions. Option A and B are repetitive and do not encourage further exploration of the situation. Option C offers a false promise and reassurance that the nurse cannot guarantee, which may not be helpful in addressing the client's needs.

2. A physician is explaining a procedure to a patient that may cure her recurring Staph infection. The doctor explains how the procedure is done, what to expect, the odds of the procedure curing the infection, and possible side effects and risks. The physician is:

• A. Preparing the patient to give informed consent.
• B. Protecting HIPAA by listing all the steps of the procedure with the risks involved.
• C. Not required to inform the patient of any alternative therapies.
• D. None of the above.

Correct answer: A

Rationale: The correct answer is preparing the patient to give informed consent. Giving informed consent is the process of providing a patient with all necessary information about a medical procedure, including how it's done, what to expect, the likelihood of success, and potential risks and side effects. This allows the patient to make an informed decision about their treatment. Protecting HIPAA (Health Insurance Portability and Accountability Act) involves safeguarding patient health information and is not directly related to the scenario described. It is important for physicians to inform patients of any alternative therapies available to them to ensure they have all relevant information to make a decision regarding their treatment. Therefore, choice C, 'Not required to inform the patient of any alternative therapies,' is incorrect. Choice D, 'None of the above,' is incorrect as the physician is indeed preparing the patient for informed consent.

3. The chain of infection includes the ________________.

• A. germ, agent, reservoir, exit portal, mode of transmission, entry port, and susceptible host
• B. active natural, active artificial, passive natural, and passive artificial
• C. opportunism, weakness, immunity, and colonization
• D. intrinsic, extrinsic, internal, and external transmission

Correct answer: A

Rationale: The chain, or cycle, of infection includes the germ (microorganism), agent, reservoir, exit portal, mode of transmission, entry port, and susceptible host. This sequence describes how infections are passed from one person to another. Choice B is incorrect because it refers to types of immunity, not components of the chain of infection. Choice C is also incorrect as it lists terms unrelated to the chain of infection. Choice D is incorrect as it describes transmission types, not components of the chain of infection. Understanding the chain of infection is crucial in preventing the spread of infections by breaking one or more links in the chain, such as interrupting the mode of transmission through proper hand hygiene.

4. When should discharge training and planning begin for a 65-year-old man admitted to the hospital for spinal stenosis surgery?

• A. Following surgery
• B. Upon admission
• C. Within 48 hours of discharge
• D. Preoperative discussion

Correct answer: B

Rationale: Discharge training and planning should begin upon admission for a patient undergoing spinal stenosis surgery. It is crucial to initiate this process early to ensure a smooth transition from hospital care to home or a rehabilitation facility. Starting discharge planning upon admission allows for comprehensive involvement of the patient, family, and healthcare team, which can reduce the risk of readmission, optimize recovery, ensure proper medication management, and adequately prepare caregivers. Therefore, option B, 'Upon admission,' is the correct answer. Options A, C, and D are incorrect because waiting until after surgery, within 48 hours of discharge, or during preoperative discussion would not provide sufficient time for effective discharge planning and education.

5. The BRAT diet is often prescribed for patients with gastroenteritis. This acronym stands for:

• A. Bananas, Rice, Applesauce, and Toast
• B. Bread, Rice, Apricots, and Tapioca
• C. Bananas, Rolls, Apricots, and Toast
• D. Bananas, Rolls, Applesauce, and Tapioca

Correct answer: A

Rationale: The BRAT diet, which stands for Bananas, Rice, Applesauce, and Toast, is commonly recommended for patients with gastroenteritis. These easily digestible foods help firm up stools due to their low fiber content and provide essential nutrients lost during vomiting and diarrhea. Choice B is incorrect because it includes apricots, which are not part of the traditional BRAT diet. Choice C is incorrect as it includes rolls, which are not typically included in the BRAT diet. Choice D is incorrect as it includes tapioca, which is not part of the traditional BRAT diet. Therefore, the correct answer is Bananas, Rice, Applesauce, and Toast.

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