Nursing Elites

1. What is the first thing you should do before sharing information with a patient?

• A. Provide background knowledge
• B. Ask for permission
• C. Remove personal protective equipment (PPE)
• D. Remind the patient that you are the authority

Correct answer: B

Rationale: Before sharing information with a patient, it is essential to ask for their permission. This action respects the patient's autonomy and encourages their participation in the learning process. Asking for permission establishes a foundation of trust and partnership between the healthcare provider and the patient. Providing background knowledge (Choice A) is important, but it should come after receiving consent to share information. Removing personal protective equipment (Choice C) is not related to the communication process. Reminding the patient that you are the authority (Choice D) is inappropriate as it can undermine the patient's autonomy and hinder effective communication in a patient-centered care approach.

2. Cariogenic foods and beverages, which are fermentable carbohydrates that can be metabolized by oral bacteria, reduce salivary pH to what critical level?

• A. 5
• B. 5.5
• C. 6
• D. 6.5

Correct answer: B

Rationale: Cariogenic foods and beverages lower the pH level in the mouth to below 5.5. This is a critical threshold, as it is the point at which enamel begins to demineralize, increasing the risk of dental caries. Therefore, options 'A', 'C', and 'D' are incorrect. Although a pH level of 5, as suggested by option 'A', would indeed lead to demineralization, it's not the threshold value. The pH levels suggested by options 'C' and 'D' (6 and 6.5, respectively) are higher than the critical value of 5.5, which means they would not initiate enamel demineralization and the subsequent risk of dental caries.

3. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. The nurse is completing a nutritional assessment on a client. Which statement made by the client is most concerning to the nurse?

• A. "I notice when I take a vitamin E supplement, I bruise more easily."
• B. "I work nights and rarely go outside during the day."
• C. "I take warfarin, so I need to limit the amount of green leafy vegetables I eat."
• D. "My vitamin supplement has the recommended daily allowance of vitamin A."

Correct answer: A

Rationale: The correct answer is A. Excessive intake of vitamin E can increase the risk of bleeding as it acts as a blood thinner. Bruising easily may indicate too much vitamin E. Choice B is not as concerning as it describes a lifestyle that may lead to vitamin D deficiency due to lack of sunlight exposure. Choice C shows awareness of the interaction between warfarin and vitamin K, which is expected. Choice D indicates knowledge of the vitamin A content in the supplement, which is not a cause for concern.

5. What type of drug would most likely be given to a patient following a myocardial infarction?

• A. antiemetic
• B. anticoagulant
• C. anticonvulsant
• D. antibiotic

Correct answer: B

Rationale: Anticoagulants are the most suitable choice for a patient following a myocardial infarction. These medications are essential in preventing further blood clots from forming in the arteries, reducing the risk of complications such as strokes or recurrent heart attacks. Antiemetics are used to control nausea and vomiting, not directly related to myocardial infarction. Anticonvulsants are used to manage seizures, not typically indicated after a heart attack. Antibiotics are prescribed to treat bacterial infections, not routinely given after a myocardial infarction.

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