Nursing Elites

1. Which of the following best describes evidence-based practice?

• A. Using outdated research
• B. Relying on personal experience alone
• C. Integrating clinical expertise with the best available evidence
• D. Disregarding patient preferences

Correct answer: C

Rationale: Evidence-based practice involves integrating clinical expertise with the best available evidence to make informed decisions about patient care. Choice A is incorrect as evidence-based practice relies on current and relevant research. Choice B is incorrect as it emphasizes the importance of not relying solely on personal experience. Choice D is incorrect as patient preferences play a significant role in evidence-based practice.

2. Which of the following is a benefit of the U.S. health-care system?

• A. With cost savings from technology, more Americans now have health-care insurance.
• B. Quality of care has improved in the United States.
• C. Care in the United States has shifted to a prevention focus rather than an illness focus.
• D. The use of technology is projected to decrease health-care costs and improve clinical outcomes.

Correct answer: D

Rationale: The correct answer is D because the use of technology and electronic health records is projected to decrease health-care costs and improve clinical outcomes, quality, and safety. Choice A is incorrect because it states that very few Americans have no health-care insurance, which is not a benefit of the U.S. health-care system. Choice B may be true, but it does not directly address a benefit of the health-care system. Choice C is not necessarily a benefit but rather a shift in focus, so it is also incorrect.

3. Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?

• A. Leukemia
• B. Histoplasmosis
• C. Pneumocystis jiroveci
• D. Rheumatoid arthritis

Correct answer: D

Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.

4. A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding of isolation guidelines?

• A. I will have a client who is on airborne precautions wear a mask when out of their room.
• B. I will wear an N95 respirator mask for a client who is on droplet precautions.
• C. I will place a client who has compromised immunity in a negative-pressure airflow room.
• D. I will instruct visitors to wear a mask when visiting a client who is on contact precautions.

Correct answer: A

Rationale: The correct answer is A. Having a client on airborne precautions wear a mask when out of their room is appropriate to prevent the spread of infection. Choice B is incorrect because the healthcare provider, not the client, wears an N95 respirator mask for a client on droplet precautions. Choice C is incorrect because negative-pressure airflow rooms are used for clients with airborne infections, not compromised immunity. Choice D is incorrect because visitors, not clients, should wear a mask when visiting a client on contact precautions.

5. A nurse at a long-term care facility is planning a fall prevention program for the residents. Which of the following interventions should the nurse include?

• A. Apply vest restraints to residents who are confused
• B. Keep all four side rails up on beds at night
• C. Accompany residents over 85 years of age during ambulation
• D. Implement rounds every 2 hours during the day to offer toileting

Correct answer: D

Rationale: The correct answer is to implement rounds every 2 hours during the day to offer toileting. This intervention helps prevent falls by addressing the common cause of unassisted mobility, which is the need to use the bathroom. Choice A is incorrect as restraints should not be the first choice for fall prevention due to the risk of injury and loss of independence. Choice B is incorrect because all side rails up can lead to entrapment and should only be used based on individualized assessments. Choice C may not be feasible for all residents over 85 years old and does not directly address the risk of falls.

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