Nursing Elites

1. An occupational health nurse is preparing to teach a health promotion class for workers at a warehouse. Which of the following statements should the nurse include?

• A. Rub your hands together for at least 10 seconds when washing them.
• B. Keep your abdominal muscles tightened when lifting objects.
• C. Ensure that 20% or less of calories come from saturated fats.
• D. Engage in aerobic exercise 2 to 4 days per week for 20 minutes.

Correct answer: B

Rationale: The correct statement to include is to 'Keep your abdominal muscles tightened when lifting objects.' This practice helps protect the back from injury by providing core stability. Rubbing hands together for 10 seconds when washing them (Choice A) is a good hygiene practice, but not directly related to warehouse work safety. Ensuring 20% or less of calories come from saturated fats (Choice C) is important for overall health but not specific to workplace safety. Engaging in aerobic exercise 2 to 4 days per week for 20 minutes (Choice D) is beneficial for health but not as directly relevant to preventing injuries while working in a warehouse.

2. A client who is 97 years old has successfully been treated for heart failure and is found not breathing. There is no DNR order in place. What should the nurse do?

• A. Notify the family and await further instructions.
• B. Initiate CPR and call for emergency assistance.
• C. Allow the family to make decisions about care.
• D. Follow the family's wishes and perform no interventions.

Correct answer: B

Rationale: In this scenario, with no DNR order in place and the client not breathing, the nurse should initiate CPR and call for emergency assistance. Option A is incorrect as immediate action is required in the absence of breathing. Option C is incorrect as the nurse should act promptly to provide life-saving measures. Option D is incorrect because the nurse's primary duty is to provide care in the absence of a directive preventing intervention.

3. A nurse is preparing to measure a client's level of oxygen saturation and observes edema of both hands and thickened toenails. The nurse should apply the pulse oximeter probe to which of the following locations?

• A. Finger
• B. Earlobe
• C. Toe
• D. Skin fold

Correct answer: B

Rationale: When a client has edema of both hands and thickened toenails, these conditions can impede accurate readings from the finger and toe locations. The earlobe is the best alternative site for the pulse oximeter probe in this scenario. Placing the probe on the earlobe will help ensure a more accurate measurement of oxygen saturation despite the issues with the hands and toenails. Therefore, the correct answer is to apply the pulse oximeter probe to the earlobe. Choices A, C, and D are incorrect because of the potential limitations presented by the edema and thickened toenails.

4. A client undergoing surgery refuses to remove religious jewelry. What is the best course of action?

• A. Proceed with surgery while securing the jewelry to the patient.
• B. Remove the jewelry and document the removal.
• C. Document the refusal and delay the surgery.
• D. Remove the jewelry with the family's permission.

Correct answer: B

Rationale: The correct course of action is to remove the jewelry and document the removal. While religious beliefs should be respected, ensuring patient safety during surgery is crucial. Securing the jewelry may not be sufficient to prevent any interference during the surgical procedure. Documenting the removal is important for legal and documentation purposes. Delaying the surgery or removing the jewelry with the family's permission may not be the best options as patient safety should be the top priority in this situation.

5. A nurse manager is teaching a group of employees about standards for Quality and Safety Education for Nurses (QSEN). Which of the following statements by an employee should the nurse manager identify as an example of the QSEN concept of quality improvement?

• A. We should start tracking how soon clients are discharged after laparoscopic versus open surgery.
• B. We should involve our clients' partners in care planning as much as possible.
• C. We should be sure to log out of the computers immediately following documentation.
• D. We should provide change-of-shift report as a team, including the assistive personnel who assisted with care.

Correct answer: B

Rationale: Involving partners in care planning is a quality improvement strategy that aligns with QSEN principles. This choice reflects patient-centered care and collaboration, which are essential elements of quality improvement. Choices A, C, and D do not directly relate to quality improvement concepts. Tracking discharge times, logging out of computers, and providing change-of-shift reports are important practices but not specifically focused on quality improvement.

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