Nursing Elites

1. When caring for a client who is on contact precautions, which of the following measures should the nurse include in the teaching?

• A. Remove the protective gown after leaving the client's room.
• B. Place the client in a room with negative pressure.
• C. Wear gloves when providing care to the client.
• D. Wear a mask when in the client's room.

Correct answer: C

Rationale: Contact precautions are used for clients with known or suspected infections that are spread by direct or indirect contact. The most important measure for healthcare workers when caring for a client on contact precautions is to wear gloves when providing care. This helps prevent the transmission of infectious agents between the client and the healthcare worker. Removing the protective gown after leaving the client's room, placing the client in a room with negative pressure, and wearing a mask when in the client's room are not specific to contact precautions and may not be necessary for all clients on contact precautions.

2. What is the most important legal responsibility for the healthcare team after a patient's death in a hospital?

• A. Obtaining consent for an autopsy
• B. Notifying the coroner or medical examiner
• C. Labeling the body appropriately
• D. Ensuring the attending physician issues the death certificate

Correct answer: D

Rationale: After a patient's death in a hospital, the most crucial legal responsibility for the healthcare team is ensuring that the attending physician issues the death certificate. The death certificate is a vital legal document that confirms the cause of death and is required for legal and administrative purposes, including the completion of the patient's medical records and facilitating the family's ability to proceed with funeral arrangements and insurance claims. While other actions such as obtaining consent for an autopsy, notifying the coroner or medical examiner, and labeling the body appropriately are important, ensuring the timely and accurate issuance of the death certificate takes precedence in this scenario.

3. Parenteral penicillin can be administered as an:

• A. IM injection or an IV solution
• B. IV or an intradermal injection
• C. Intradermal or subcutaneous injection
• D. IM or a subcutaneous injection

Correct answer: A

Rationale: Penicillin can be administered intramuscularly or intravenously.

4. A client is receiving vecuronium for acute respiratory distress syndrome. Which of the following medications should the nurse anticipate administering with this medication?

• A. Fentanyl
• B. Furosemide
• C. Famotidine
• D. Dexamethasone

Correct answer: A

Rationale: Vecuronium is a neuromuscular blocking agent used for muscle relaxation during mechanical ventilation. When administering vecuronium, it is common to also give an opioid analgesic, such as fentanyl, to manage pain and ensure the patient's comfort. Fentanyl is often used in combination with neuromuscular blocking agents to provide balanced anesthesia, making it the appropriate medication to anticipate administering in this scenario.

5. A caregiver is caring for a 5-month-old infant who has manifestations of severe dehydration and a prescription for parenteral fluid therapy. The caregiver asks, 'What are the indications that my baby needs an IV?' Which of the following responses should the caregiver make?

• A. Your baby needs an IV because she is not producing any tears
• B. Your baby needs an IV because her fontanels are bulging
• C. Your baby needs an IV because she is breathing slower than normal
• D. Your baby needs an IV because her heart rate is decreasing

Correct answer: A

Rationale: The correct response is A: 'Your baby needs an IV because she is not producing any tears.' In infants, the inability to produce tears is a sign of severe dehydration. This is a crucial indication for the need for intravenous (IV) fluid therapy to rehydrate the infant. While the other options may also be symptoms of dehydration, the absence of tears is a more direct and specific indicator requiring immediate attention and intervention.

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