Nursing Elites

1. Which of the following factors increases the risk of developing a pressure ulcer?

• A. High-protein diet
• B. Frequent repositioning
• C. Immobility
• D. Active range of motion exercises

Correct answer: C

Rationale: Immobility is a significant risk factor for pressure ulcers because it leads to prolonged pressure on specific areas of the body, reducing blood flow and leading to tissue breakdown. Choices A, B, and D are incorrect. A high-protein diet can actually aid in wound healing and tissue repair. Frequent repositioning helps relieve pressure on bony prominences, reducing the risk of pressure ulcers. Active range of motion exercises can improve circulation and prevent muscle atrophy, thereby reducing the risk of pressure ulcers.

2. When preparing a sterile field for a procedure, which action should the nurse take to maintain sterility?

• A. Place sterile items around the sterile field
• B. Keep hands below waist level to avoid contamination
• C. Open the sterile package away from the body
• D. Avoid reaching over the sterile field

Correct answer: D

Rationale: To maintain sterility when preparing a sterile field, it is essential to avoid reaching over the sterile field. This action can introduce contaminants from the nurse's clothing or unsterile areas, compromising the sterility of the field. Placing sterile items around the sterile field (choice A) is incorrect as it may increase the risk of contamination by extending the area where non-sterile items may come in contact. Keeping hands below waist level (choice B) is also incorrect as it does not prevent contamination effectively. Opening the sterile package away from the body (choice C) is incorrect since it exposes the contents to the nurse's body, which is not sterile.

3. A client has a prescription for a transcutaneous electrical nerve stimulator (TENS) unit for pain management during the postoperative period following a lumbar laminectomy. Which information should the nurse reinforce about the action of this adjuvant pain modality?

• A. The discharge of electricity will distract the client's focus from the pain
• B. An infusion of medication in the spinal canal will block pain perception
• C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus
• D. A mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain

Correct answer: D

Rationale: The correct answer is D. TENS works by delivering a mild electrical stimulus to the skin, which can help close the 'gates' in the nervous system to block pain signals from reaching the brain, thus reducing pain perception. Choice A is incorrect because TENS does not distract from pain but rather helps manage it. Choice B is incorrect as it describes a different pain management technique involving medication in the spinal canal. Choice C is incorrect because TENS acts peripherally on nerve conduction rather than dulling pain perception in the cerebral cortex.

4. When teaching a patient about the side effects of a new medication, which teaching method is most effective?

• A. Providing a written pamphlet
• B. Giving verbal instructions only
• C. Demonstrating how to take the medication
• D. Using a combination of verbal, written, and demonstration methods

Correct answer: D

Rationale: The most effective teaching method when educating a patient about the side effects of a new medication is to use a combination of verbal, written, and demonstration methods. This comprehensive approach ensures that the patient receives information through multiple channels, catering to different learning styles. Verbal instructions allow for direct communication, written materials provide a reference for the patient to review later, and demonstrations offer a visual aid that can enhance understanding. Providing a combination of these methods increases the likelihood of the patient retaining and comprehending the information effectively. Choices A, B, and C are less effective as they do not encompass the benefits of utilizing multiple teaching modalities.

5. Which of the following is MOST LIKELY to increase the risk of a medication error?

• A. Not using abbreviations for medications
• B. Errors in the calculation of medication dosages
• C. Barcoding medication orders
• D. Utilizing unit dose dispensers

Correct answer: B

Rationale: Errors in the calculation of medication dosages are a significant risk factor for medication errors. When dosage calculations are incorrect, it can lead to administering the wrong amount of medication, posing serious harm to the patient. Avoiding abbreviations for medications, barcoding medication orders, and utilizing unit dose dispensers are all strategies aimed at reducing medication errors by enhancing accuracy and safety. Therefore, choices A, C, and D are incorrect as they are practices that help decrease, rather than increase, the risk of medication errors.

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