Nursing Elites

1. A nurse manager is implementing a quality improvement project to reduce the number of methicillin-resistant Staphylococcus aureus (MRSA) infections at the facility. Which of the following actions should the nurse manager take first?

• A. Develop an MRSA protocol for implementation.
• B. Provide educational in-services for staff.
• C. Evaluate outcomes resulting from interventions.
• D. Conduct a chart review to evaluate precipitating factors of clients who develop MRSA.

Correct answer: D

Rationale: Conducting a chart review to evaluate the precipitating factors of clients who develop MRSA is the initial step in reducing these infections. By identifying factors contributing to MRSA infections, the nurse manager can develop targeted interventions. Developing an MRSA protocol (choice A) and providing educational in-services (choice B) would be premature without understanding the specific factors at play. Evaluating outcomes (choice C) should come after implementing interventions based on the findings from the chart review.

2. A nurse is caring for a patient postoperatively after a thyroidectomy. Which of the following findings should be reported immediately?

• A. Hoarseness
• B. Difficulty swallowing
• C. Numbness in the fingers
• D. Tingling around the mouth

Correct answer: D

Rationale: Tingling around the mouth should be reported immediately as it may indicate hypocalcemia, a serious complication resulting from accidental removal or damage to the parathyroid glands during thyroidectomy. Hoarseness and difficulty swallowing are common post-thyroidectomy symptoms related to the surgery itself and the manipulation of the vocal cords and nearby structures. Numbness in the fingers is not typically associated with immediate serious complications of a thyroidectomy.

3. Which of the following is a correct method of safely using a sterile dressing?

• A. Reuse a dressing that appears clean.
• B. Discard a dressing after 24 hours of use.
• C. Change a dressing only if there is visible drainage.
• D. Change a dressing every 4 hours regardless of condition.

Correct answer: B

Rationale: The correct method of safely using a sterile dressing is to discard it after 24 hours of use. This is important to prevent contamination and promote proper wound healing. Choice A is incorrect because reusing a dressing, even if it appears clean, can introduce contaminants. Choice C is incorrect as dressing changes should not be based solely on visible drainage; they should be done within the recommended time frame. Choice D is incorrect because changing a dressing every 4 hours, regardless of its condition, can lead to unnecessary wastage and disturbance to the wound healing process.

4. The surgical mask the perioperative nurse is wearing becomes moist. Which action will the perioperative nurse take next?

• A. Do not change the mask if the nurse is comfortable.
• B. Change the mask when relieved by the next shift.
• C. Apply a new mask.
• D. Reapply the mask after it air-dries.

Correct answer: C

Rationale: When a surgical mask becomes moist, it loses its effectiveness as a barrier against microorganisms. Therefore, the perioperative nurse should apply a new mask. Choice A is incorrect because a moist mask should not be continued to be worn even if the nurse is comfortable. Choice B is not the best course of action as the mask should be changed immediately when it becomes moist. Choice D is also incorrect as waiting for the mask to air-dry is not recommended due to the loss of barrier effectiveness.

5. A nurse is providing discharge teaching for a client prescribed warfarin. What should be included in the teaching?

• A. Avoid foods rich in vitamin K
• B. Take warfarin with meals
• C. Take aspirin for pain relief
• D. Report unusual bleeding or bruising

Correct answer: D

Rationale: The correct answer is D. When a client is prescribed warfarin, they should be educated to report any unusual bleeding or bruising promptly. Choices A, B, and C are incorrect. Avoiding foods rich in vitamin K is not necessary when taking warfarin, as long as intake remains consistent. Warfarin does not need to be taken with meals, and aspirin should not be taken for pain relief due to its blood-thinning effects, which can increase the risk of bleeding when combined with warfarin.

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