Nursing Elites

1. The Sims' position is MOST similar to the ________ position.

• A. prone
• B. lateral
• C. supine
• D. Fowler's

Correct answer: B

Rationale: The correct answer is 'lateral.' The Sims' position is characterized by the patient lying on their side with the upper knee flexed and the upper arm positioned in front of the body. This is similar to the lateral position where the patient is also lying on their side. The prone position (choice A) is when the patient lies face down, the supine position (choice C) is when the patient lies face up, and Fowler's position (choice D) is a seated position with the head of the bed elevated at a 45-90 degree angle. Therefore, the lateral position is the most similar to the Sims' position as both involve the patient lying on their side.

2. In the Gram Stain procedure, which component acts as the mordant?

• A. Crystal violet
• B. Methyl alcohol
• C. Iodine
• D. Safranin

Correct answer: C

Rationale: In the Gram Stain procedure, the mordant is Gram's Iodine. The purpose of the mordant is to form a complex with the crystal violet, enhancing its ability to bind to the cell wall. Crystal violet is actually the primary stain used in the Gram Stain procedure to initially color all cells. Methyl alcohol is the decolorizer that removes the crystal violet from certain cell types. Safranin is the counterstain used to stain those cells that did not retain the crystal violet stain after the decolorization step.

3. What is the most important step that healthcare personnel can take to prevent the transmission of microorganisms in the hospital setting?

• A. Wear protective eyewear at all times.
• B. Wear gloves whenever in direct contact with patients.
• C. Wash hands before and after contact with each patient.
• D. Clean the stethoscope with an alcohol swab between patients.

Correct answer: C

Rationale: The most crucial step in preventing the transmission of microorganisms in the hospital setting is proper hand hygiene. Healthcare personnel should wash their hands thoroughly before and after each patient contact to reduce the risk of spreading infections. While cleaning the stethoscope with an alcohol swab between patients is recommended, it is secondary to hand hygiene. Wearing protective eyewear at all times is not necessary for routine patient care unless specifically indicated, and wearing gloves only when in direct contact with patients is important but not as critical as proper handwashing. Therefore, the correct answer is to wash hands before and after contact with each patient.

4. What term is used to refer to generalized wasting of body tissues and malnutrition?

• A. Entropion
• B. Confabulation
• C. Induration
• D. Cachexia

Correct answer: D

Rationale: Cachexia is the correct term used to describe the generalized wasting of body tissues, ill health, and malnutrition associated with some chronic diseases. It involves a loss of fat tissue to protect the bones and joints. Clients with cachexia are at risk of pressure ulcers and other complications due to malnutrition and poor health. Entropion refers to an eyelid condition, confabulation is a memory disturbance, and induration is the abnormal hardening of a part of the body.

5. During an assessment, the nurse notices that a patient is handling a small charm that is tied to a leather strip around their neck. Which action by the nurse is appropriate?

• A. Ask the patient about the item and its significance.
• B. Ask the patient to lock the item with other valuables in the hospital's safe.
• C. Tell the patient that a family member should take valuables home.
• D. No action is necessary.

Correct answer: A

Rationale: The small charm tied to a leather strip is likely an amulet, which many cultures consider an important means of protection from 'evil spirits.' When a patient appears to have a health practice the nurse is unfamiliar with, the nurse should ask for clarification in a non-judgmental way that communicates acceptance of their beliefs and allows for open communication. Thus, the nurse in this situation should inquire about the amulet's meaning to the patient. Asking the patient to lock the item with other valuables in the hospital's safe, telling the patient that a family member should take valuables home, or doing nothing does not address the importance or meaning of a cultural health practice to the patient and does not allow the nurse to gain an understanding of the patient's cultural health practices.

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