Nursing Elites

1. Which clinical findings indicate positive signs and symptoms of schizophrenia?

• A. Withdrawal, poverty of speech, inattentiveness
• B. Flat affect, decreased spontaneity, asocial behavior
• C. Hypomania, labile mood swings, episodes of euphoria
• D. Bizarre behavior, auditory hallucinations, loose associations

Correct answer: D

Rationale: The correct answer is bizarre behavior, auditory hallucinations, and loose associations. These are positive symptoms of schizophrenia, reflecting a distortion or excess of normal function. Withdrawal, poverty of speech, inattentiveness, flat affect, decreased spontaneity, and asocial behavior are negative symptoms linked to schizophrenia, indicating a diminution or absence of normal function. Hypomania, labile mood swings, and episodes of euphoria are more characteristic of bipolar disorder, rather than schizophrenia.

2. Which component of cultural competence is being demonstrated when the nurse motivates the immigrant to accept differences in the way a pregnant woman is cared for in her current residence?

• A. Cultural desire
• B. Cultural awareness
• C. Cultural knowledge
• D. Cultural encounters

Correct answer: A

Rationale: The correct answer is 'Cultural desire.' Cultural desire involves the nurse's motivation and commitment toward caring for individuals from diverse backgrounds. In this scenario, motivating the immigrant to accept differences in prenatal care reflects the nurse's genuine interest in providing culturally competent care. Cultural awareness involves self-examination of one's beliefs and biases. Cultural knowledge refers to understanding various cultural practices and beliefs. Cultural encounters focus on interactions across cultures to enhance communication and mutual understanding. Therefore, in this context, the nurse's actions align more closely with the concept of cultural desire.

3. Which is an example of an intentional tort?

• A. Negligence
• B. Malpractice
• C. Breach of duty
• D. False imprisonment

Correct answer: D

Rationale: False imprisonment is a clear example of an intentional tort where one person deliberately confines another without lawful justification. It involves intentional, wrongful restraint of a person's freedom of movement. Negligence, on the other hand, is an unintentional tort that occurs when someone fails to exercise reasonable care, resulting in harm to others. Malpractice, which involves professional negligence, is also classified as an unintentional tort as it is a failure to meet the standard of care expected in a particular profession. Breach of duty, while a legal concept, is not an example of an intentional tort. It refers to a failure to fulfill a legal obligation or duty owed to another party, often leading to legal consequences, but it is not categorized as an intentional tort.

4. A nurse stops at a motor vehicle collision site to render aid until the emergency personnel arrive and applies pressure to a groin wound that is bleeding profusely. Later the client has to have the leg amputated and sues the nurse for malpractice. Which is the most likely outcome of this lawsuit?

• A. The Patient's Bill of Rights protects clients from malicious intents, so the nurse could lose the case.
• B. The lawsuit may be settled out of court, but the nurse's license is likely to be revoked.
• C. There will be no judgment against the nurse, whose actions were protected under the Good Samaritan Act.
• D. The client will win because the four elements of negligence (duty, breach, causation, and damages) can be proved.

Correct answer: C

Rationale: The Good Samaritan Act protects healthcare professionals who provide care in good faith from malpractice claims, regardless of the client outcome. In this scenario, the nurse stopped at the scene voluntarily to render aid, which is protected under the Good Samaritan Act. This law shields individuals from legal liability when providing emergency care in good faith and without expectation of compensation. The Patient's Bill of Rights does protect clients, but in this case, the nurse's actions were protected by the Good Samaritan Act. Additionally, the state Board of Nursing would not likely revoke the nurse's license unless there was evidence of actions taken in bad faith or unreasonable care. The client would not win the lawsuit as the essential elements of malpractice, including duty, breach, causation, and damages, were not met in this situation.

5. At a senior citizens meeting, a healthcare professional talks with a client who has Type 1 diabetes mellitus. Which statement by the client during the conversation is most predictive of a potential for impaired skin integrity?

• A. ''I give myself insulin injections in my thighs.''
• B. ''Sometimes when I put my shoes on, I don't know where my toes are.''
• C. ''Here are my glucose readings that I noted on my calendar.''
• D. ''If I bathe more than once a week, my skin feels too dry.''

Correct answer: B

Rationale: The correct answer is when the client states, ''Sometimes when I put my shoes on, I don't know where my toes are.'' This statement indicates peripheral neuropathy, which can lead to a lack of sensation in the lower extremities. When clients are unable to feel pressure or pain in their feet, they are at a high risk for skin impairment, such as cuts, wounds, or ulcers. Option A is not directly related to impaired skin integrity, as self-administering insulin in the thighs does not pose a direct risk to skin integrity. Option C shows good glucose monitoring, which is important but does not directly indicate impaired skin integrity. Option D suggests dry skin due to infrequent bathing, which is more related to general skin care and not as predictive of impaired skin integrity as the statement in Option B.

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