Nursing Elites

1. The nurse-manager is planning to transform safety ideas into prevention and protection strategies in the workplace. What committee should review and plan policies and education about safety in the workplace?

• A. policy and procedures committee
• B. quality assurance committee
• C. education committee
• D. ethics committee

Correct answer: B

Rationale: The quality assurance committee is responsible for reviewing and planning policies and education related to workplace safety. This committee focuses on ensuring the quality of care and services provided, which includes implementing safety measures. The policy and procedures committee primarily deals with developing and maintaining organizational policies and procedures. The education committee focuses on educational programs and initiatives, not specifically on safety policies. The ethics committee is concerned with ethical issues and dilemmas, not safety policies and education.

2. While performing an initial assessment on a newborn following a breech delivery, the nurse suspects hip dislocation. Which of the following is most suggestive of the abnormality?

• A. Flexion of lower extremities
• B. Negative Ortolani response
• C. Lengthened leg of affected side
• D. Irregular hip symmetry

Correct answer: D

Rationale: Irregular hip symmetry, such as asymmetry in the gluteal folds, is a common sign of hip dislocation in newborns. This finding indicates a potential abnormality in hip development and requires further evaluation and possible treatment. Choices A, B, and C are incorrect. Flexion of lower extremities is a normal newborn reflex, the Ortolani response is used to detect hip dysplasia rather than hip dislocation, and a lengthened leg of the affected side is not typically associated with hip dislocation in newborns.

3. As community health nurses engage in the process of community empowerment, it is essential that they:

• A. gather data from the community
• B. form partnerships with people in the community
• C. make decisions for the people in the community
• D. accept responsibility for people's actions

Correct answer: B

Rationale: In the process of community empowerment, community health nurses should form partnerships with the community rather than making decisions for them, gathering data alone, or accepting responsibility for their actions. Forming partnerships ensures that the community is actively involved in decision-making processes, leading to sustainable and effective outcomes. Gathering data is important but not the central aspect of empowerment, while accepting responsibility for people's actions is not a core principle of empowerment but rather promoting accountability within the community.

4. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

• A. "Feedings can begin in 5 to 7 days."
• B. "The use of the feeding tube can begin immediately."
• C. "The stomach contents and air must be drained first."
• D. "The incision healing must be complete before feeding."

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

5. The nurse is caring for an acutely ill 10-year-old client. Which of the following assessments would require the nurse's immediate attention?

• A. Rapid bounding pulse
• B. Temperature of 38.5 degrees Celsius
• C. Profuse diaphoresis
• D. Slow, irregular respirations

Correct answer: D

Rationale: The correct answer is D, slow, irregular respirations. In an acutely ill child, this assessment can indicate impending respiratory failure or neurological compromise, necessitating immediate intervention. Rapid bounding pulse (choice A) may indicate tachycardia but is not as immediately concerning as compromised respirations. A temperature of 38.5 degrees Celsius (choice B) is elevated but may not be the most urgent concern unless accompanied by other symptoms. Profuse diaphoresis (choice C) can indicate increased sympathetic activity but is not as critical as respiratory compromise.

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