Nursing Elites

1. When assessing the pulse of a 6-year-old patient, the nurse notices that the heart rate varies with the respiratory cycle, speeding up at the peak of inspiration and slowing to normal with expiration. What action would the nurse take next?

• A. Notify the physician.
• B. Record this finding as normal.
• C. Check the child's blood pressure and note any variation with respiration.
• D. Document that this child has bradycardia and continue with the assessment.

Correct answer: B

Rationale: The correct action for the nurse to take next is to record this finding as normal. Sinus dysrhythmia, characterized by heart rate variation with the respiratory cycle, is commonly found in children and young adults. The heart rate speeds up at the peak of inspiration and slows to normal with expiration. This phenomenon is a normal variant and does not require any intervention. There is no need to notify the physician as this finding is within the expected range for this age group. Checking the child's blood pressure for variations with respiration or documenting the child as having bradycardia would not be appropriate in this case, as sinus dysrhythmia is a normal physiological response.

2. What are Korotkoff sounds?

• A. Sounds noted during diastole.
• B. The result of the vibration of blood against artery walls while blood pressure readings are being taken.
• C. Sounds only noted by skilled cardiologists.
• D. Distinct sounds which are classified into 6 phases.

Correct answer: B

Rationale: Korotkoff sounds are the sounds that occur when blood flows in an artery that has been temporarily compressed during a blood pressure measurement. These sounds result from the vibration of blood against the artery walls as the pressure cuff is released. There are five distinct phases of Korotkoff sounds, which healthcare providers are trained to identify during blood pressure assessment. The correct answer, choice B, accurately describes the nature of Korotkoff sounds and how they are generated. Choices A, C, and D are incorrect because Korotkoff sounds are not specific to diastole, not limited to skilled cardiologists, and categorized into five phases, not six.

3. A patient's Foley catheter has been discontinued. You will dispose of this patient equipment by doing which of the following?

• A. Wearing gloves and then placing this equipment in the regular trash can after it is placed in a paper bag.
• B. Simply placing this equipment in the regular trash can after it is placed in a paper bag.
• C. Wearing gloves and then placing this equipment into a special 'hazardous waste' container.
• D. Simply placing this equipment in the 'hazardous waste' container after it is placed in a paper bag.

Correct answer: C

Rationale: When disposing of used patient equipment, such as a Foley catheter, that has come in contact with bodily fluids, it is considered hazardous waste. The correct procedure involves wearing gloves and placing the Foley bag and tubing into a special 'hazardous waste' container. This container is marked as 'Hazardous' and is typically red to indicate the potential danger of its contents. Placing the equipment in a regular trash can, even if placed in a paper bag, is not appropriate as it does not meet the standards for disposing of hazardous waste. Therefore, options A and B are incorrect. Similarly, simply placing the equipment in a 'hazardous waste' container after it is placed in a paper bag is also incorrect as direct disposal into the designated container while wearing gloves is the proper protocol, making option D incorrect.

4. Which of the following is an example of an environmental hazard that may put the healthcare professional at risk of injury?

• A. Loud noise from the hospital maintenance system
• B. Airborne powder containing latex
• C. Chemicals containing ethylene oxide
• D. All of the above

Correct answer: D

Rationale: Healthcare professionals, including nurses, are exposed to various environmental hazards that may negatively impact their physical or mental health. Hazards come in several forms, such as loud noise from hospital systems, which can damage hearing; airborne latex powder, leading to allergic reactions; and chemicals like ethylene oxide, a sterilizing agent that can cause cancer. Therefore, all the options listed pose risks to healthcare professionals, making 'All of the above' the correct answer. Choice A, loud noise, is a hazard that can affect hearing health. Choice B, airborne latex powder, can trigger allergic responses. Choice C, chemicals containing ethylene oxide, are hazardous and can lead to serious health issues. Each option represents a distinct environmental risk that healthcare professionals should be aware of and take precautions against.

5. The nurse is reviewing the hot/cold theory of health and illness. Which statement best describes the basic tenets of this theory?

• A. The causation of illness is based on supernatural forces that influence the humors of the body.
• B. Herbs and medicines are classified based on their physical characteristics of hot and cold and the humors of the body.
• C. The four humors of the body consist of blood, yellow bile, black bile, and phlegm.
• D. The treatment of disease consists of adding or subtracting cold, heat, dryness, or wetness to restore the balance of the humors of the body.

Correct answer: D

Rationale: The hot/cold theory of health and illness is based on the four humors of the body: blood, phlegm, black bile, and yellow bile. These humors regulate the basic bodily functions, described in terms of temperature, dryness, and moisture. The treatment of disease in this theory involves adding or subtracting cold, heat, dryness, or wetness to restore the balance of the humors. Choice A is incorrect as the theory is not based on supernatural forces but on the balance of bodily humors. Choice B is incorrect as herbs and medicines are not classified solely based on their physical characteristics of hot and cold in this theory. Choice C is incorrect as the four humors are blood, phlegm, black bile, and yellow bile, not spiritual connectedness or social aspects. Therefore, the correct choice is D, as it accurately reflects a foundational tenet of the hot/cold theory of health and illness.

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