Nursing Elites

1. When planning care for a client on mechanical ventilation, which mode of ventilation that increases the effort of the client's respiratory muscles should NOT be included in the plan of care?

• A. Assist-control
• B. Synchronized intermittent mandatory ventilation
• C. Continuous positive airway pressure
• D. Pressure support ventilation

Correct answer: A

Rationale: Assist-control ventilation mode delivers a preset tidal volume at a set rate; however, it may not be suitable for clients who need to maintain some level of respiratory muscle activity. This mode provides full support for each breath, potentially leading to decreased respiratory muscle strength over time. Therefore, it is important to avoid using assist-control mode for clients who require increased effort of respiratory muscles to prevent muscle atrophy and promote optimal respiratory function.

2. Which of the following interventions is considered the most effective form of universal precautions?

• A. Cap all used needles before removing them from their syringes
• B. Discard all used uncapped needles and syringes in an impenetrable protective container
• C. Wear gloves when administering IM injections
• D. Follow enteric precautions

Correct answer: B

Rationale: The most effective form of universal precautions is to discard all used uncapped needles and syringes in an impenetrable protective container. This practice minimizes the risk of needle-stick injuries, which are a significant concern when dealing with used needles. By safely disposing of uncapped needles, healthcare providers can protect themselves and others from potential exposure to bloodborne pathogens.

3. A healthcare provider reaches to answer the telephone on a busy pediatric unit, momentarily turning away from a 3-month-old infant she has been weighing. The infant falls off the scale, suffering a skull fracture. The healthcare provider could be charged with:

• A. Defamation
• B. Assault
• C. Battery
• D. Malpractice

Correct answer: D

Rationale: The scenario described involves a breach of duty by the healthcare provider to properly supervise the infant, resulting in harm. This failure to meet the standard of care falls under the category of malpractice, which refers to professional negligence or misconduct. Malpractice specifically applies to situations where a healthcare provider's actions or omissions deviate from the accepted standard of care, causing harm to a patient. In this case, the nurse's lack of supervision leading to the infant falling off the scale and sustaining a skull fracture would be considered malpractice.

4. If a healthcare provider administers an injection to a patient who refuses, they have committed:

• A. Assault and battery
• B. Negligence
• C. Malpractice
• D. None of the above

Correct answer: A

Rationale: When a healthcare provider administers treatment, such as an injection, against a patient's refusal or will, it constitutes assault and battery. Assault refers to the intentional act that causes a person to fear that they will be touched without consent, while battery involves the actual harmful or offensive contact. In this scenario, administering the injection without the patient's consent is both an assault (causing fear of unwanted contact) and a battery (unwanted physical contact). Therefore, the correct answer is 'Assault and battery.' Negligence refers to a failure to exercise the appropriate level of care expected in a situation, while malpractice involves professional negligence or misconduct.

5. A client complains of difficulty swallowing when the nurse tries to administer capsule medication. Which of the following measures should the nurse take?

• A. Dissolve the capsule in a glass of water
• B. Break the capsule and give the contents with applesauce
• C. Check the availability of a liquid preparation
• D. Crush the capsule and place it under the tongue

Correct answer: C

Rationale: When a client has difficulty swallowing capsule medication, the nurse should check the availability of a liquid preparation. This is a safer approach and ensures that the medication's integrity is maintained, providing an alternative form that is easier for the client to take. Dissolving the capsule in water (choice A) may alter the medication's effectiveness, breaking the capsule and mixing the contents with applesauce (choice B) is not recommended as it may cause an unpleasant taste, and crushing the capsule and placing it under the tongue (choice D) can be unsafe and affect the medication's absorption.

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