Nursing Elites

1. During preoperative teaching for a client scheduled for a total knee arthroplasty who speaks a different language than the nurse, which interprofessional team member should the nurse include in the discussion?

• A. Interpreter
• B. Social worker
• C. Occupational therapist
• D. Spiritual advisor

Correct answer: A

Rationale: In this scenario, the nurse should include an interpreter in the discussion to facilitate clear and accurate communication between the nurse and the client who speaks a different language. The interpreter plays a crucial role in ensuring that the client fully understands the preoperative teaching and can express any concerns or questions effectively. Choice B, a social worker, is not the most appropriate option in this context as the primary need is language interpretation rather than social support. Choice C, an occupational therapist, is also not the best option as their role does not directly address the language barrier issue. Choice D, a spiritual advisor, is not relevant to the situation at hand and would not assist in overcoming the language barrier.

2. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

3. When a nurse reads a peer-reviewed nursing journal article recommending a change in caring for a patient with an indwelling urinary catheter, which action demonstrates critical thinking?

• A. Implementing the article's recommendations in caring for a patient with an indwelling urinary catheter
• B. Presenting the journal article to the nurse manager and proposing a revision of the procedure
• C. Seeking additional peer-reviewed articles that corroborate the author's recommendation
• D. Disregarding the article and adhering to the facility's existing procedure

Correct answer: C

Rationale: Critical thinking involves evaluating information from various sources. In this scenario, the nurse displays critical thinking by seeking additional peer-reviewed articles that support the author's recommendation. This action ensures that decisions are based on a comprehensive understanding of the topic rather than relying solely on one source. By exploring other peer-reviewed articles, the nurse can validate the proposed change and make informed decisions regarding patient care. Choice A, implementing the article's recommendations, may not encompass a thorough evaluation of the information presented. Choice B, presenting the article to the nurse manager, is a valid step but does not directly involve critical analysis of the information. Choice D, disregarding the article, goes against the essence of critical thinking, which emphasizes the evaluation and consideration of various perspectives.

4. While supervising the care of several clients, which action requires intervention by the charge nurse?

• A. A nurse photocopies a client's diagnostic test results.
• B. An assistive personnel documents the client's vital signs on the client's paper-based graphic record.
• C. The unit secretary faxes a client's laboratory results to the provider.
• D. An RN stays with a client to discuss her understanding of her vital signs that were requested.

Correct answer: A

Rationale: The charge nurse should intervene when a nurse photocopies a client's diagnostic test results as it violates patient confidentiality and privacy. This action breaches HIPAA regulations, and sensitive patient information should not be photocopied without proper authorization. The other actions are within the scope of practice and do not raise concerns regarding patient privacy or confidentiality.

5. In an underdeveloped country, the nurse observes the natives lighting ritual fires and pounding on primitive drums around the sick person to promote recovery. The nurse interprets this behavior as indicating the natives believe illness results from which items?

• A. Pathogens and genetics
• B. Evil spirits
• C. Tides and planets
• D. Plants and animals

Correct answer: B

Rationale: The behavior of lighting fires and pounding on drums to promote recovery suggests a belief in evil spirits causing illness. In many cultures, rituals like these are performed to ward off evil spirits or negative energies that are thought to be the cause of sickness. Choices A, C, and D are incorrect as the described behavior aligns more with spiritual or supernatural beliefs rather than scientific explanations related to pathogens, genetics, tides, planets, plants, or animals.

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