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. When a family of an accident victim, who has been declared brain-dead, appears open to organ donation, what should the nurse do?

• A. Discourage them from deciding until their grief has eased
• B. Listen to their concerns and answer their questions truthfully
• C. Urge them to immediately sign the consent form
• D. Inform them that the body will not be available for a wake or funeral

Correct answer: B

Rationale: In situations involving potential organ donation, the nurse's role is to provide support, listen to the family's concerns, and answer their questions truthfully. By doing so, the nurse can help facilitate an informed and respectful decision-making process for the grieving family.

3. 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.

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 client is in a seclusion room following violent behavior and continues to display aggressive behavior. What action should the nurse take?

• A. Confront the client about this behavior.
• B. Express sympathy for the client's situation.
• C. Speak assertively to the client.
• D. Stand within 30 cm (1 ft) of the client when speaking with them.

Correct answer: A

Rationale: When a client in a seclusion room following violent behavior continues to display aggression, it is essential for the nurse to confront the client about this behavior. Confrontation can help set boundaries, address the behavior, and ensure the safety of both the client and the healthcare team. Expressing sympathy (Choice B) may not address the immediate need for behavior management. Speaking assertively (Choice C) can be important but should be coupled with addressing the specific behavior. Standing within close proximity (Choice D) of an aggressive client can escalate the situation and compromise safety, so it is not the appropriate action to take.

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