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 was exposed to anthrax. Which of the following antibiotics should be administered?

• A. Fluconazole
• B. Tobramycin
• C. Ciprofloxacin
• D. Vancomycin

Correct answer: C

Rationale: The correct answer is Ciprofloxacin. Ciprofloxacin is an antibiotic effective in treating anthrax exposure. Fluconazole (Choice A) is an antifungal medication used for fungal infections, not anthrax. Tobramycin (Choice B) is an antibiotic used for bacterial infections but is not the first line of treatment for anthrax. Vancomycin (Choice D) is also an antibiotic, but it is not the preferred choice for treating anthrax.

3. Which action by a nurse demonstrates effective communication with a patient?

• A. Providing the patient with written information about their care.
• B. Maintaining eye contact and listening actively to the patient.
• C. Using medical jargon to explain the patient's condition.
• D. Speaking with the patient in a hurried manner to save time.

Correct answer: B

Rationale: Maintaining eye contact and actively listening to the patient is crucial in effective communication as it helps build rapport, shows empathy, and ensures that the patient feels heard and understood. Providing written information can be helpful, but the direct interaction is essential for effective communication. Using medical jargon may confuse the patient instead of clarifying their condition. Speaking hurriedly can make the patient feel rushed and not valued, hindering effective communication.

4. A nurse is preparing to administer aspirin 650mg PO every 12 hr. The amount available is aspirin 325mg tablets. How many tablets should the nurse administer?

• A. 1 tablet
• B. 2 tablets
• C. 3 tablets
• D. 4 tablets

Correct answer: B

Rationale: The correct answer is 2 tablets. Each tablet of aspirin is 325mg. To achieve the required dose of 650mg, the nurse should administer 2 tablets. Choice A (1 tablet) is incorrect because it would only provide 325mg, which is half the required dose. Choices C (3 tablets) and D (4 tablets) are incorrect as they would exceed the required dose.

5. A nurse is observing a nursing student practicing standard precautions. Which observation by the instructor indicates that further teaching is necessary?

• A. The nursing student wears gloves when changing bed linens.
• B. The nursing student wears gloves to remove a wound dressing.
• C. The nursing student washes hands after removing gloves.
• D. The nursing student touches the patient's skin with sterile gloves.

Correct answer: D

Rationale: The correct answer is D because touching a patient's skin with sterile gloves compromises the sterility of the gloves, increasing the risk of contamination. Choices A, B, and C demonstrate correct practices in standard precautions. Wearing gloves when changing bed linens and to remove a wound dressing, as well as washing hands after removing gloves, are all appropriate and necessary steps to prevent the spread of infection.

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