Nursing Elites

1. A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?

• A. A client who reports right-sided flank pain and is diaphoretic
• B. A client who has active bleeding from a puncture wound of the left groin area
• C. A client who has a raised red skin rash on his arms, neck, and face
• D. A client who reports shortness of breath and left neck and shoulder pain

Correct answer: D

Rationale: The correct answer is D because shortness of breath with referred pain may indicate a serious condition, such as a cardiac event or pulmonary embolism, making this the highest priority. Option A, flank pain with diaphoresis, could suggest kidney-related issues but is not as immediately life-threatening as compromised breathing. Option B, active bleeding, though serious, can usually be controlled with proper interventions. Option C, a raised red skin rash, may indicate an allergic reaction but is not as urgent as respiratory distress with neck and shoulder pain.

2. A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

• A. Withhold the benzodiazepine but continue the opioid
• B. Contact the provider about replacing the opioid with an NSAID
• C. Administer the benzodiazepine but withhold the opioid
• D. Continue the medication dosages that relieve the client's pain

Correct answer: B

Rationale: The correct action for the nurse to take is to contact the provider about replacing the opioid with an NSAID. In this scenario, the client is experiencing excessive sedation after the administration of both opioid and benzodiazepine. Switching to a non-opioid analgesic like an NSAID can help manage pain effectively without causing additional sedation. Option A is incorrect because continuing the opioid may exacerbate sedation. Option C is incorrect as administering the benzodiazepine may further increase sedation. Option D is incorrect because maintaining the current medication dosages that are causing excessive sedation is not in the client's best interest.

3. Which of the following is a key benefit of interprofessional collaboration in healthcare?

• A. Increased professional isolation
• B. Improved patient outcomes
• C. Reduced need for communication
• D. Longer treatment times

Correct answer: B

Rationale: Improved patient outcomes are a key benefit of interprofessional collaboration in healthcare. Collaboration among healthcare professionals leads to better coordination of care, reduced medical errors, and improved overall patient satisfaction. The other choices are incorrect because interprofessional collaboration aims to decrease professional isolation, enhance communication among team members, and streamline treatment processes to reduce time spent on patient care.

4. Your client is adversely affected with fever, night sweats, occult hematuria, tenderness of the spleen, and Osler's nodes. What disorder would you most likely suspect?

• A. Tuberculosis
• B. AIDS/HIV
• C. Pericarditis
• D. Endocarditis

Correct answer: D

Rationale: The client is likely suffering from endocarditis based on the symptoms described. Endocarditis is characterized by fever, night sweats, hematuria, splenomegaly (tenderness of the spleen), and Osler's nodes (painful nodules on the pads of the fingers or toes). While tuberculosis and AIDS/HIV can present with some similar symptoms, the presence of Osler's nodes is more specific to endocarditis. Pericarditis typically presents with chest pain, not the combination of symptoms seen in this case.

5. Which of the following changes was enacted by the Patient Protection and Affordable Care Act?

• A. Creation of national health insurance exchanges for affordable insurance coverage
• B. Expansion of school-based health centers
• C. Free preventative services for all
• D. Medically managed clinics eligible for federal funding

Correct answer: B

Rationale: The correct answer is B. The Patient Protection and Affordable Care Act expanded school-based health centers to provide additional healthcare services to students. Choice A is incorrect because the creation of national health insurance exchanges was a key provision of the Affordable Care Act, but it was not the only change enacted by the legislation. Choice C is incorrect as while the Affordable Care Act did include provisions for free preventative services for certain groups, it was not applicable to all individuals. Choice D is incorrect as the Act did not specifically address medically managed clinics eligible for federal funding.

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