Nursing Elites

1. A patient is being taught to use TD nitroglycerin patches to treat angina pectoris. What instructions should be included?

• A. Apply a patch every 12 hours
• B. Apply a new patch every morning
• C. Use it only when symptoms appear
• D. Rotate the application site weekly

Correct answer: B

Rationale: The correct answer is to apply a new patch every morning. Nitroglycerin patches should be applied in the morning and removed at bedtime to provide a 14-hour nitrate-free interval, preventing tolerance development. Choice A is incorrect because applying a patch every 12 hours may lead to tolerance. Choice C is incorrect because nitroglycerin patches are used prophylactically, not just when symptoms appear. Choice D is incorrect because rotating the application site weekly is not necessary; the same site can be used as long as there is no skin irritation.

2. Which of the following is an example of professional negligence?

• A. Following facility guidelines at all times
• B. Using equipment in a knowledgeable manner
• C. Communicating effectively with clients
• D. Documenting client interactions accurately

Correct answer: A

Rationale: Professional negligence involves failing to meet the standard of care expected in a particular profession, which can lead to harm. In this case, not following facility guidelines can result in lapses in safety or quality of care, potentially causing harm to clients. Choices B, C, and D all represent essential aspects of professional conduct and do not directly relate to negligence.

3. A forensic nurse is using the epidemiological triangle to explain factors that contribute to violent behavior. Which of the following factors should the nurse identify as an environmental factor in the epidemiological triangle?

• A. Crowded living conditions
• B. Traumatic brain injury
• C. Alzheimer's disease
• D. Impaired coping abilities

Correct answer: A

Rationale: Crowded living conditions are considered an environmental factor in the epidemiological triangle as they can contribute to the spread of violence. In this context, environmental factors refer to external influences such as social and physical environments. Traumatic brain injury, Alzheimer's disease, and impaired coping abilities are not typically classified as environmental factors in the epidemiological triangle. Traumatic brain injury and Alzheimer's disease are more related to individual health conditions, while impaired coping abilities are more focused on individual psychological factors rather than external environmental influences.

4. What should be done to manage a patient with contact precautions?

• A. Wear a mask, gown, and gloves for all patient interactions.
• B. Ensure that visitors wear protective equipment.
• C. Dedicate all patient care equipment to that patient.
• D. Disinfect shared equipment before use.

Correct answer: C

Rationale: When managing a patient with contact precautions, it is essential to dedicate all patient care equipment to that specific patient. This practice helps minimize the risk of spreading infections to other patients. Choice A, wearing protective gear for all patient interactions, is a general precaution but not specific to managing a patient with contact precautions. Choice B, ensuring visitors wear protective equipment, is important for infection control but not directly related to managing the patient with contact precautions. Choice D, disinfecting shared equipment before use, is a good practice for infection control in general but does not address the specific needs of a patient under contact precautions.

5. A nurse is providing home care for a client who is receiving tube feedings and medication through a gastrostomy tube. The family member providing the feedings reports that the client has begun to have diarrhea. For which of the following practices should the nurse intervene?

• A. Cleanse the bag every 24 hours
• B. Cleanse the bag every 48 hours
• C. Use tap water
• D. Flush the tube every 4 hours

Correct answer: A

Rationale: The correct answer is A. Cleansing the bag every 24 hours can lead to contamination, increasing the risk of infection and diarrhea. Using tap water (choice C) is not recommended for cleaning the gastrostomy tube due to the risk of introducing harmful microorganisms. Cleansing the bag every 48 hours (choice B) is not frequent enough and may also contribute to infection. Flushing the tube every 4 hours (choice D) is a standard practice to ensure patency and should not be intervened by the nurse.

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