Nursing Elites

1. When assessing a pulse, what should be noted?

• A. Rate
• B. Rate and quality
• C. Rate, quality, and fullness
• D. Rate, quality, fullness, and regularity

Correct answer: C

Rationale: When assessing a pulse, it is important to note the rate (number of beats per minute), quality (regular or irregular), and fullness (thread and weak or full and bounding). These aspects provide crucial information about the patient's cardiovascular status. Regularity, as mentioned in option D, is not typically assessed during a pulse check and is not necessary for routine pulse assessment. Choice A is too limited as it overlooks important aspects beyond just the rate. Choice B improves by adding quality but still lacks the fullness aspect. Choice C is the most comprehensive and accurate as it includes all three essential aspects for a thorough pulse assessment.

2. During a class on the aspects of culture, the instructor shares that culture has four basic characteristics. Which statement correctly reflects one of the characteristics of culture?

• A. Static and unchanging
• B. Members sharing similar physical characteristics
• C. Members sharing a common geographic origin and religion
• D. Adapted to specific conditions related to environmental and technical factors

Correct answer: D

Rationale: Culture has four basic characteristics, one of which is that it is adapted to specific conditions related to environmental and technical factors and to the availability of natural resources. The other three characteristics are: (1) learned from birth through the processes of language acquisition and socialization; (2) shared by all members of the cultural group; and (3) dynamic and ever-changing. Culture is not static and unchanging but is dynamic and ever-changing. Members of a culture do not necessarily share similar physical characteristics; that refers to race. Similarly, members of a culture do not necessarily share a common geographic origin and religion; that refers to ethnicity.

3. Which action is appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?

• A. Listen to a patient's lung sounds for wheezes or rhonchi.
• B. Label specimens obtained during percutaneous lung biopsy.
• C. Instruct a patient about how to use home spirometry testing.
• D. Measure induration at the site of a patient's intradermal skin test.

Correct answer: B

Rationale: Labeling specimens obtained during a percutaneous lung biopsy is a task that can be appropriately delegated to unlicensed assistive personnel (UAP) as it does not require nursing judgment. UAP can perform this task safely under the supervision of a nurse. Listening to a patient's lung sounds for wheezes or rhonchi, instructing a patient about how to use home spirometry testing, and measuring induration at the site of a patient's intradermal skin test all require nursing judgment and interpretation of findings. These tasks should be performed by licensed nursing personnel to ensure accurate assessment and appropriate intervention.

4. A healthcare professional realizes after a patient has left the office that they forgot to document the patient's complaint of a sore throat. Which of the following choices would BEST correct the error?

• A. Pull out that page of the chart and rewrite it with the correct information.
• B. Put one line through the original Chief Complaint, write 'ERROR,' your initials, and today's date. Make the correction by rewriting the Chief Complaint with the correct information.
• C. Go to the next available line of the SOAP notes. Write the current date, then write 'Late Entry.' Place the date and time when the patient stated they had a sore throat. Sign and date the entry.
• D. All of the above are incorrect.

Correct answer: C

Rationale: When adding information to a patient's chart after the encounter, using the term 'Late Entry' is essential. This clearly indicates that the information was added after the fact and helps to maintain the accuracy and integrity of the medical record. Option A is incorrect because removing a page from the chart and rewriting it can lead to inaccuracies and is not a recommended practice for correcting errors. Option B suggests marking the original Chief Complaint as an error, which may not be clear to future readers of the chart and could lead to confusion. Option D is incorrect as it dismisses the correct approach outlined in Option C, which is the best way to handle the situation of missed documentation during a patient encounter.

5. When assessing a patient's pulse, which of the following characteristics would the nurse also notice?

• A. Force
• B. Pallor
• C. Capillary refill time
• D. Timing in the cardiac cycle

Correct answer: A

Rationale: When assessing a patient's pulse, the nurse should observe characteristics such as rate, rhythm, and force. Force refers to the strength or amplitude of the pulse, which provides important information about cardiac output. Pallor is the paleness of the skin and is not directly related to pulse assessment. Capillary refill time is used to assess peripheral perfusion and is not specifically part of pulse assessment. Timing in the cardiac cycle is a broader concept and not a characteristic directly assessed during a pulse examination. Therefore, choice A, 'Force,' is the correct answer as it aligns with the standard parameters evaluated during pulse assessment.

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