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. The nurse is caring for a group of medical-surgical patients. A fire has been reported in an adjacent wing of the hospital. What should the nurse do to ensure the patients' safety?

• A. Wait until the fire department arrives before taking action.
• B. Close all doors.
• C. Identify evacuation routes.
• D. Move bedridden patients in their beds.

Correct answer: B

Rationale: During a fire emergency, it is crucial to close all doors to contain smoke and fire, helping to protect the patients. This action can prevent the spread of fire and smoke to the area where patients are located. Identifying evacuation routes is also important for a timely and orderly evacuation if necessary. Waiting for the fire department to arrive before taking action (Choice A) can waste valuable time and put patients at risk. Moving bedridden patients in their beds (Choice D) can be dangerous during a fire and should be avoided as it can expose patients and staff to more risks.

3. Which intervention is most effective in preventing postoperative complications?

• A. Encourage the patient to drink fluids.
• B. Ambulate the patient as soon as possible.
• C. Perform deep breathing exercises with the patient.
• D. Encourage the patient to perform range of motion exercises.

Correct answer: B

Rationale: The most effective intervention in preventing postoperative complications is to ambulate the patient as soon as possible. Early ambulation helps prevent complications like deep vein thrombosis and pneumonia by enhancing circulation and preventing respiratory issues. Encouraging the patient to drink fluids, perform deep breathing exercises, or range of motion exercises are beneficial interventions, but ambulation is the priority due to its overall impact on preventing various postoperative complications.

4. The nurse is assessing the patient for respiratory complications of immobility. What action should the nurse take?

• A. Auscultate the entire lung region to assess lung sounds.
• B. Assess the patient at least every 4 hours.
• C. Focus auscultation on the upper lung fields.
• D. Inspect chest wall movements primarily during the expiratory cycle.

Correct answer: A

Rationale: Auscultating the entire lung region is the most appropriate action when assessing a patient for respiratory complications related to immobility. This approach helps the nurse identify any abnormalities in lung sounds, such as diminished breath sounds or the presence of secretions. Assessing the patient at regular intervals (choice B) is important but does not specifically address the respiratory assessment needed in this situation. Focusing auscultation on the upper lung fields (choice C) may miss potential issues in other areas. Inspecting chest wall movements primarily during the expiratory cycle (choice D) is not the most effective way to assess lung sounds and identify respiratory complications.

5. The nurse is preparing a care plan for a patient who is immobile. Which psychosocial aspect will the nurse assess for?

• A. Loss of weight
• B. Loss of bone mass
• C. Loss of hope
• D. Loss of strength

Correct answer: C

Rationale: When a patient is immobile, the nurse should assess for psychosocial aspects, including a loss of hope and increased risk of depression. While issues like weight loss (choice A), loss of bone mass (choice B), and loss of strength (choice D) can also occur due to immobility, the primary concern in this scenario is the patient's mental and emotional well-being, making 'Loss of hope' the correct answer.

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