Nursing Elites

1. The charge nurse is observing a student nurse caring for a 4-month-old infant in isolation diagnosed with RSV. Which of the following would indicate to the charge nurse that the student nurse needs further instruction on isolation standards?

• A. Donning clean gloves each time she goes in the room.
• B. Wearing a clean mask each time she goes in the room.
• C. Labeling the door so staff will use Airborne Precautions.
• D. Wearing a gown when she goes in the room to administer medication.

Correct answer: A

Rationale: The correct answer is 'Donning clean gloves each time she goes in the room.' Sterile gloves are not necessary for standard isolation precautions; clean gloves are sufficient. The student nurse should be instructed to use clean gloves to reduce the risk of spreading infections. Wearing a clean mask each time she goes in the room is a good practice to prevent the spread of respiratory infections like RSV. Labeling the door for Airborne Precautions is appropriate for RSV. Wearing a gown when entering the room to administer medication helps prevent the transmission of infectious agents.

2. Which of the following is likely to increase the risk of sexually transmitted disease?

• A. alcohol use
• B. certain types of sexual practices
• C. oral contraception use
• D. all of the above

Correct answer: D

Rationale: All of the above factors are likely to increase the risk of sexually transmitted diseases (STDs). Alcohol use can impair judgment, leading to risky sexual behavior. Certain types of sexual practices, especially unprotected sex or multiple partners, increase the likelihood of contracting STDs. While oral contraception use does not directly increase the risk of STDs, it does not protect against them either. Therefore, all the choices (alcohol use, certain types of sexual practices, and oral contraception use) can contribute to an increased risk of contracting STDs.

3. The nurse manager is having a problem on the unit with one staff person having repetitive tardiness and leaving the unit with orders not initiated. Which action by the manager would be best?

• A. Call the staff nurse in and place them on a work improvement plan after a 3-day suspension
• B. Have the other staff gather additional information on the tardy staff member
• C. Call the staff nurse in for an interview to investigate the problem and possible solutions
• D. Assign a mentor to assist the staff member in arriving on time

Correct answer: C

Rationale: The correct action for the nurse manager would be to call the staff nurse in for an interview to discuss the issues of repetitive tardiness and incomplete tasks. This approach allows the staff member to explain the situation, and together with the manager, develop a plan to address the problems. Choice A is incorrect as it immediately involves suspension without investigation or support. Choice B is not the best course of action as it does not involve direct communication with the staff member in question. Choice D, assigning a mentor to help the staff member, could be beneficial but does not directly address the immediate issues of tardiness and incomplete tasks.

4. A one-month-old infant in the neonatal intensive care unit is dying. The parents request that the nurse administer an opioid analgesic to their infant, who is crying weakly. The infant's heart rate is 68 beats per minute, and the respiratory rate is 18 breaths per minute. The infant is on room air, and the oxygen saturation is 92%. The nurse's response is based on which of the following principles?

• A. Providing analgesia during the last days and hours is an ethically appropriate nursing action.
• B. Withholding the opioid analgesia during the last days and hours is an ethical duty because administering it would represent assisted suicide.
• C. Administering analgesia during the last days and hours is the parents' ethical decision.
• D. Withholding the opioid analgesia is clinically appropriate because it will hasten the infant's death.

Correct answer: A

Rationale: All patients, regardless of age, have the right to die with dignity and be free from pain. In this case, the parents' request for an opioid analgesic to relieve the child's distress aligns with the principles of palliative care and ensuring comfort. Assisted suicide involves a conscious decision by the individual, which is not applicable to a 1-month-old infant. Both the nurse and the parents have an ethical duty to ensure the infant's comfort and well-being. Withholding opioid analgesia solely to hasten death is not appropriate, as providing pain relief is a crucial aspect of end-of-life care. Opioids can be administered to dying patients at any age to alleviate suffering without the intention of hastening death. Therefore, providing analgesia during the last days and hours is an ethically appropriate nursing action. Choices B, C, and D are incorrect because the decision to administer analgesia in this scenario is based on the best interest and comfort of the infant, not concerns about assisted suicide or hastening death. The ethical consideration is to provide compassionate care and alleviate suffering.

5. How can the nurse promote relief of muscle pain, spasms, and tension?

• A. Encouraging the client to continue their activities as usual.
• B. Immobilizing the client.
• C. Applying heat, cold, pressure, or vibration to the painful area.
• D. Administering pain medication as needed to ease the muscle.

Correct answer: C

Rationale: To promote relief of muscle pain, spasms, and tension, the nurse should consider applying heat, cold, pressure, or vibration to the painful area. These interventions can help alleviate pain associated with muscle tension, pain, or spasms. Choice A is incorrect because encouraging the client to continue their activities as usual may exacerbate the pain. Choice B is incorrect as immobilizing the client may not address the underlying issue and could potentially lead to further complications. Choice D is also incorrect because while pain medication can be used, it is not the first-line treatment for muscle pain, spasms, and tension.

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