Nursing Elites

1. Which action by a graduate nurse would require the charge nurse to intervene?

• A. Walking in the hallway outside the operating room without a hair covering
• B. Putting on a surgical mask, gown, and cap before entering the operating room
• C. Wearing a surgical mask into the holding area
• D. Wearing scrubs from home into the nursing station

Correct answer: A

Rationale: The correct answer is walking in the hallway outside the operating room without a hair covering. In healthcare settings, it is crucial to adhere to infection control measures, which include wearing appropriate attire to prevent the spread of pathogens. Walking in the hallway outside the operating room without a hair covering violates these infection control protocols, necessitating immediate intervention by the charge nurse. Choices B and C are incorrect because putting on surgical attire before entering the operating room and wearing a surgical mask into the holding area are both standard practices that promote patient safety and infection control. Choice D is also incorrect as wearing scrubs from home into the nursing station, while not ideal, is not a violation that warrants immediate intervention compared to breaching infection control protocols near sensitive areas like the operating room.

2. A young female teenager describes a brutal assault and rape to the nurse on duty. Which of the following actions should the nurse take first?

• A. Check with the case manager on duty about possible police intervention.
• B. Provide an environment of concern and emotional stabilization.
• C. Clean the patient's wounds with normal saline and gauze.
• D. Refer the patient to a counselor specializing in trauma.

Correct answer: B

Rationale: In a situation where a patient describes a brutal assault and rape, the first priority should be to provide emotional support and create a safe and supportive environment. This helps the patient feel secure and cared for, which is crucial for their well-being at that moment. Checking with the case manager about police intervention should come after ensuring the patient's immediate emotional needs are addressed. Cleaning the patient's wounds, though important, can be secondary to providing emotional stabilization. Referring the patient to a counselor specializing in trauma is also crucial for long-term support, but the immediate focus should be on providing emotional support and stability.

3. Which of the following medications is a serotonin antagonist that might be used to relieve nausea and vomiting?

• A. metoclopramide (Reglan)
• B. ondansetron (Zofran)
• C. hydroxyzine (Vistaril)
• D. prochlorperazine (Compazine)

Correct answer: B

Rationale: Zofran is a serotonin antagonist that can be used to relieve nausea and vomiting. Ondansetron (Zofran) works by blocking serotonin receptors in the chemoreceptor trigger zone (CTZ) and the gastrointestinal tract. This action helps reduce nausea and vomiting. Metoclopramide (Reglan) works as a dopamine antagonist and also has prokinetic effects, making it effective for different conditions. Hydroxyzine (Vistaril) is an antihistamine with antiemetic properties, but it does not act as a serotonin antagonist. Prochlorperazine (Compazine) is a dopamine antagonist that is also used to treat nausea and vomiting, but not as a serotonin antagonist like ondansetron.

4. An RN on your unit has had an argument with the family of a client regarding the way in which the RN has changed the client's dressing. The family is adamant that the dressing change was performed incorrectly. The RN insists that sterile technique was observed. As an RN manager, what is the best response?

• A. Meet with the family member and the RN to discuss the disagreement regarding the dressing change.
• B. Talk to the family member and assure them that the nurse followed the hospital procedure.
• C. Discuss the dressing change procedure with the RN and compare it to a current textbook.
• D. Change the RN's assignment the next day to another client.

Correct answer: A

Rationale: When conflict occurs, it is best to meet with both parties together to discuss the problem. This approach allows each party to hear what the other is saying and prevents the RN manager from being caught in the middle. By facilitating a discussion between the family member and the RN, they can work together to find a resolution or the manager can mediate. This promotes open communication, understanding, and collaboration. Option A is the correct choice because it emphasizes addressing the conflict directly and seeking a mutual understanding. Option B is incorrect because just assuring the family member may not address the underlying issues. Option C is incorrect as it does not involve the family member in the resolution process. Option D is inappropriate as it doesn't address the conflict but rather avoids it by changing the RN's assignment.

5. A healthcare professional is reviewing a patient's serum glucose levels. Which of the following scenarios would indicate abnormal serum glucose values for a 30-year-old male?

• A. 70 mg/dL
• B. 55 mg/dL
• C. 110 mg/dL
• D. 100 mg/dL

Correct answer: B

Rationale: The correct answer is 55 mg/dL. The standard range for serum glucose levels is typically 60-115 mg/dL. A serum glucose level of 55 mg/dL falls below this range, indicating hypoglycemia. Options A, C, and D are within the standard range for serum glucose levels and would not be considered abnormal for a 30-year-old male.

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