Nursing Elites

1. Which of the following is an example of a tertiary prevention activity?

• A. Administering immunizations
• B. Physical therapy for stroke patients
• C. Routine health screenings
• D. Health education campaigns

Correct answer: B

Rationale: The correct answer is B, physical therapy for stroke patients. Tertiary prevention aims to prevent complications and improve the quality of life for individuals who already have a disease or condition. Administering immunizations (choice A) is an example of primary prevention to prevent the onset of diseases. Routine health screenings (choice C) are part of secondary prevention to detect diseases early. Health education campaigns (choice D) typically fall under primary prevention by educating and promoting healthy behaviors to prevent diseases.

2. A nurse manager needs to resolve a conflict between the staff nurses and the physical therapy department. What type of power might the manager utilize? (EXCEPT)

• A. Connection and referent power
• B. Reward and punishment power
• C. Legitimate power
• D. Information power

Correct answer: C

Rationale: In this scenario, the nurse manager may utilize various types of power to resolve the conflict between the staff nurses and the physical therapy department. Referent power and connection power are based on respect/admiration and influential links, respectively. Information power is about access to valuable data. Reward power involves offering inducements for cooperation, while punishment power is about imposing penalties for non-compliance. Legitimate power, however, is derived from the manager's authority associated with their job and rank. Since the question asks for the type of power the manager might utilize 'EXCEPT,' legitimate power, being a key type of power often used in managerial roles, is the correct answer. It's important for the nurse manager to understand the dynamics of power and utilize the appropriate types to effectively address interdepartmental conflicts.

3. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

• A. give a bolus of 50% dextrose.
• B. insert a large-bore IV catheter.
• C. initiate oxygen via nasal cannula.
• D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

4. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: Clients may request a DNR order, but they need to be fully informed of all the ramifications of the decision. Therefore, the health-care provider will consult with the client and family before the order is written.

5. An RN enters a patient�s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?

• A. The RN tells the client he is not allowed to leave until the physician has released him.
• B. The RN asks the client why he wishes to leave.
• C. The RN asks the client to explain what he understands about his medical diagnosis.
• D. The RN asks the client to sign an against medical advice discharge form.

Correct answer: A

Rationale: Verbal or physical detainment of a client who desires to leave the institution is false imprisonment.

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