Nursing Elites

1. Staff refuse to report unsafe conditions, with unattended entrances throughout the health care facility noted. Unidentified individuals are wandering the unit at night, and you:

• A. Establish expectations.
• B. Demand that they leave immediately.
• C. Ask them to leave.
• D. Observe their behaviors.

Correct answer: A

Rationale: In this scenario, the correct course of action is to establish expectations. By setting clear guidelines and expectations, you can address the issue of unidentified individuals wandering the unit at night in a proactive manner. This approach helps communicate what behaviors are acceptable, ensuring the safety of both staff and patients. Demanding that they leave immediately may not address the root cause of the problem and could escalate the situation. Simply observing their behaviors may not effectively resolve the issue or prevent future incidents. Asking them to leave without first establishing expectations may not prevent similar occurrences in the future.

2. When planning a budget, the nurse manager knows that costs depend on and change in direct proportion to patient volume and activity. What type of costs are these?

• A. Variable costs
• B. Indirect costs
• C. Fixed costs
• D. Direct costs

Correct answer: A

Rationale: Variable costs vary in direct proportion to patient volume and activity. These costs increase or decrease based on the level of patient care provided. Indirect costs are not directly tied to patient volume, fixed costs remain constant regardless of patient volume, and direct costs are directly attributable to patient care but may not vary with patient volume and activity. Therefore, the correct answer is 'Variable costs.'

3. Which of the following statements is true regarding nursing ethics?

• A. Nursing ethics focus on the organizational level at the workplace.
• B. Nursing ethics focus on the duties and rules of behavior for professional nurses.
• C. Nursing ethics focus on the moral character of nurses.
• D. Nursing ethics focus on the experiences and needs of nurses.

Correct answer: B

Rationale: The correct answer is B: 'Nursing ethics focus on the duties and rules of behavior for professional nurses.' Nursing ethics primarily revolve around the principles and standards that guide the actions and decisions of nurses in their professional roles. Choice A is incorrect as nursing ethics are not limited to the organizational level but extend to individual conduct. Choice C is incorrect as while moral character is important, nursing ethics encompass more than just character traits. Choice D is incorrect as nursing ethics are centered on professional responsibilities rather than personal experiences and needs.

4. Which of the following is an example of a secondary prevention strategy?

• A. Administering flu vaccinations
• B. Screening for hypertension
• C. Performing a mastectomy
• D. Providing rehabilitation after surgery

Correct answer: B

Rationale: Screening for hypertension is indeed an example of a secondary prevention strategy. Secondary prevention aims to detect and treat a disease in its early stages to prevent complications. Administering flu vaccinations (Choice A) is an example of primary prevention, aimed at preventing the disease from occurring. Performing a mastectomy (Choice C) is a treatment for an existing condition and not a preventive strategy. Providing rehabilitation after surgery (Choice D) is a form of tertiary prevention that focuses on restoring function and improving quality of life after an illness or injury.

5. A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?

• A. Amitriptyline decreases the depression caused by your foot pain.
• B. Amitriptyline helps prevent transmission of pain impulses to the brain.
• C. Amitriptyline corrects some of the blood vessel changes that cause pain.
• D. Amitriptyline improves sleep and reduces awareness of nighttime pain.

Correct answer: B

Rationale: The correct answer is B. Amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, which helps in reducing the transmission of pain impulses to the brain. Choice A is incorrect because amitriptyline primarily works on pain transmission rather than directly on depression. Choice C is inaccurate as amitriptyline's mechanism of action is not related to correcting blood vessel changes. Choice D is partially true as amitriptyline can improve sleep, but the primary mechanism related to pain relief is by preventing pain impulses from reaching the brain.

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