Nursing Elites

1. In a centralized decision-making process within an organization, where is the authority to make decisions vested?

• A. Every employee
• B. A few individuals, such as the board of directors
• C. Many individuals, with decisions filtering down to the individual employee
• D. All nursing employees, pharmacists, and hospital health care providers

Correct answer: B

Rationale: In a centralized decision-making process within an organization, the authority to make decisions is concentrated in a few individuals, such as the board of directors. This means that key decision-making power is held by a select group at the top of the organizational hierarchy. Choices A, C, and D are incorrect because in a centralized structure, decision-making authority is not distributed among every employee, does not filter down to individual employees, and is not shared among all nursing employees, pharmacists, or hospital health care providers. Centralized decision-making implies a more top-down approach.

2. To assess a client's ankle ROM, which ROM exercises should the nurse have them perform?

• A. flexion, extension, hyperextension
• B. flexion, extension, abduction, adduction
• C. external rotation, internal rotation
• D. extension, flexion, inversion, eversion

Correct answer: D

Rationale: The correct answer is extension, flexion, inversion, and eversion. These exercises help assess the full range of motion of the ankles. Flexion and extension evaluate the bending and straightening movements of the ankle joint, respectively. Inversion and eversion assess the inward and outward movements of the foot at the ankle joint. Hyperextension, abduction, and adduction are not specific movements of the ankle joint, making choices A and B incorrect. External and internal rotation are movements more related to joints like the hip or shoulder, not the ankle, making choice C incorrect.

3. What condition is mammography used to detect?

• A. pain
• B. tumor
• C. edema
• D. epilepsy

Correct answer: B

Rationale: Mammography is specifically used to detect tumors or abnormal growths, especially in breast tissue. It is not a tool for identifying pain, edema, or epilepsy. Therefore, the correct answer is 'tumor.' Pain is a symptom, edema is swelling, and epilepsy is a neurological disorder; none of these are conditions typically detected through mammography.

4. The advanced directive in a client's chart is dated August 12, 1998. The client's daughter produces a Power of Attorney for Health Care, dated 2003, which contains different care directions. What should the nurse do?

• A. Follow the 1998 version because it's part of the legal chart.
• B. Follow the 1998 version because the physician's code order is based on it.
• C. Follow the 2003 version, place it in the chart, and communicate the update appropriately.
• D. Follow neither until clarified by the unit manager.

Correct answer: C

Rationale: The document dated 2003 supersedes the previous version and should be used as a basis for care directions. The nurse should follow the 2003 version, place it in the chart, and communicate the update appropriately to ensure that the most current care directions are followed. Choices A and B are incorrect because the 1998 version is now outdated, and the nurse should not rely on it for care decisions. Choice D is incorrect because the nurse should not delay following the updated document, and seeking clarification from the unit manager can lead to avoidable delays in care.

5. The nurse should teach parents of small children that the most common type of first-degree burn is:

• A. scalding from hot bath water or spills
• B. contact with hot surfaces such as stoves and fireplaces
• C. contact with flammable liquids or gases resulting in flash burns
• D. sunburn from lack of protection and overexposure

Correct answer: D

Rationale: The most common type of first-degree burn in small children is sunburn, often due to lack of protection and overexposure to the sun. This type of burn highlights the importance of educating parents about using sunscreens and ensuring children are adequately protected from the sun's harmful rays. Choices A, B, and C describe scenarios that can lead to burns but are not the most common type of first-degree burn in small children, making them incorrect.

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