Nursing Elites

1. A nurse manager of a rural clinic is orienting a new employee. Which of the following information should the nurse include as a characteristic of rural health?

• A. Lower rates of maternal morbidity
• B. Reduced incidence of death from motor-vehicle crashes
• C. Increased rates of chronic illness
• D. More frequent dental preventative care visits

Correct answer: C

Rationale: The correct answer is C: 'Increased rates of chronic illness.' Rural areas often face challenges such as limited access to healthcare services, healthcare provider shortages, socioeconomic factors, and lifestyle choices that contribute to higher rates of chronic illnesses. Maternal morbidity rates are typically higher in rural areas due to limited access to obstetric care. While rural areas may have fewer motor-vehicle crashes compared to urban areas, the severity of crashes is usually higher due to factors like longer emergency response times. Dental care access can also be limited in rural areas, leading to less frequent preventative care visits.

2. A client is preparing for a surgical procedure but refuses to remove religious jewelry. What is the best course of action?

• A. Proceed with surgery and document the refusal.
• B. Ask the client for permission to secure the jewelry.
• C. Remove the jewelry and store it safely.
• D. Postpone the surgery until the jewelry is removed.

Correct answer: B

Rationale: The best course of action is to ask the client for permission to secure the jewelry. This respects the client's religious beliefs while also ensuring that the jewelry does not interfere during the surgical procedure. Proceeding with surgery without addressing the presence of the jewelry can lead to complications or distress for the client. Removing the jewelry without consent or postponing the surgery solely due to the presence of religious jewelry are not appropriate actions in this situation.

3. The nurse is working on an orthopedic rehabilitation unit that requires lifting and positioning of patients. Which personal injury will the nurse most likely try to prevent?

• A. Hip
• B. Back
• C. Arm
• D. Ankle

Correct answer: B

Rationale: The correct answer is B: Back. Back injuries are most common during lifting and bending tasks, especially in an orthopedic unit. When lifting or repositioning patients, nurses must prioritize proper body mechanics to prevent strain on the back. Choices A, C, and D are less likely to occur as frequently as back injuries in this scenario because of the nature of the tasks involved in orthopedic patient care.

4. What is a key component of a comprehensive discharge plan for a patient with heart failure?

• A. Advising on appropriate physical activity and exercise
• B. Fluid restriction to prevent fluid overload
• C. Dietary recommendations, including a low-sodium diet
• D. Medication management, including diuretics and ACE inhibitors

Correct answer: A

Rationale: The main components of a comprehensive discharge plan for a patient with heart failure include advising on appropriate physical activity and exercise to improve cardiovascular health and overall well-being. While fluid restriction and dietary recommendations are important aspects of heart failure management, advising on physical activity and exercise is crucial for improving cardiac function and quality of life post-discharge. Medication management is also essential but focusing on physical activity is particularly relevant for long-term management and preventing readmissions.

5. A nurse is caring for a client who had a stroke involving the right cerebral hemisphere. The nurse should monitor for which of the following findings?

• A. Deficits in the right visual field
• B. Unable to discriminate words and letters
• C. Motor retardation
• D. Poor impulse control

Correct answer: D

Rationale: The correct answer is D, poor impulse control. Right hemisphere strokes commonly affect judgment and safety awareness, leading to poor impulse control. Choices A, B, and C are incorrect for this scenario. Deficits in the right visual field are associated with left hemisphere strokes, while the inability to discriminate words and letters is typically seen with left hemisphere damage. Motor retardation is more common in strokes affecting the motor areas of the brain, not specifically related to right hemisphere strokes.

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