Nursing Elites

1. Which of the following signs and symptoms would the nurse expect to find when assessing an Asian patient for postoperative pain following abdominal surgery?

• A. Decreased blood pressure and heart rate and shallow respirations
• B. Quiet crying
• C. Immobility, diaphoresis, and avoidance of deep breathing or coughing
• D. Changing position every 2 hours

Correct answer: C

Rationale: Immobility, diaphoresis, and avoidance of deep breathing or coughing are common signs of pain.

2. What is the most important legal responsibility for the healthcare team after a patient's death in a hospital?

• A. Obtaining consent for an autopsy
• B. Notifying the coroner or medical examiner
• C. Labeling the body appropriately
• D. Ensuring the attending physician issues the death certificate

Correct answer: D

Rationale: After a patient's death in a hospital, the most crucial legal responsibility for the healthcare team is ensuring that the attending physician issues the death certificate. The death certificate is a vital legal document that confirms the cause of death and is required for legal and administrative purposes, including the completion of the patient's medical records and facilitating the family's ability to proceed with funeral arrangements and insurance claims. While other actions such as obtaining consent for an autopsy, notifying the coroner or medical examiner, and labeling the body appropriately are important, ensuring the timely and accurate issuance of the death certificate takes precedence in this scenario.

3. A patient requires augmentation of labor. Which of the following conditions should the nurse recognize as a contraindication to the use of oxytocin?

• A. Diabetes mellitus
• B. Shoulder presentation
• C. Postterm with oligohydramnios
• D. Chorioamnionitis

Correct answer: C

Rationale: Postterm pregnancy with oligohydramnios is a contraindication for the use of oxytocin due to the increased risk of uterine hyperstimulation and fetal distress. Oxytocin can further stress the fetus in this scenario, potentially leading to adverse outcomes. Therefore, it is crucial for the nurse to recognize this contraindication to ensure the safety of both the mother and the baby during labor.

4. When a family of an accident victim, who has been declared brain-dead, appears open to organ donation, what should the nurse do?

• A. Discourage them from deciding until their grief has eased
• B. Listen to their concerns and answer their questions truthfully
• C. Urge them to immediately sign the consent form
• D. Inform them that the body will not be available for a wake or funeral

Correct answer: B

Rationale: In situations involving potential organ donation, the nurse's role is to provide support, listen to the family's concerns, and answer their questions truthfully. By doing so, the nurse can help facilitate an informed and respectful decision-making process for the grieving family.

5. A healthcare provider is caring for a group of clients. Which of the following clients is not at risk for pulmonary embolism?

• A. A client who has a BMI of 30
• B. A female client who is postmenopausal
• C. A client who has a fractured femur
• D. A client who has chronic atrial fibrillation

Correct answer: B

Rationale: Postmenopausal status is not a significant risk factor for pulmonary embolism. Risk factors for pulmonary embolism include obesity (BMI of 30 or higher), immobility such as having a fractured femur, and conditions like chronic atrial fibrillation that increase the risk of blood clot formation. While postmenopausal status may be associated with other health risks, it is not directly linked to an increased risk of pulmonary embolism.

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