Nursing Elites

1. Who is legally able to make decisions for the patient or resident during a patient care conference when the patient is not mentally able to make decisions on their own?

• A. The patient or their healthcare proxy
• B. Only the patient
• C. Only the healthcare proxy
• D. The doctor

Correct answer: C

Rationale: When a patient is unable to make decisions due to mental incapacity, the healthcare proxy, designated by the patient in advance, has the legal authority to make decisions on the patient's behalf. In this situation, the patient lacks the capacity to make decisions independently. The healthcare proxy's role is to represent the patient's wishes and best interests. The doctor's role in a patient care conference is to provide medical expertise, offer recommendations, and assist in the decision-making process, but the final decision-making authority lies with the healthcare proxy, not the doctor.

2. A client is complaining of pain that starts in the shoulder and travels down the length of his arm. This type of pain is referred to as:

• A. Referred pain
• B. Superficial pain
• C. Radiating pain
• D. Precipitating pain

Correct answer: C

Rationale: Radiating pain is the correct term for pain that originates in one part of the body and extends to other related areas. In this scenario, the pain starting in the shoulder and traveling down the arm describes radiating pain. Referred pain (Choice A) is pain felt at a site different from the actual origin of the pain. Superficial pain (Choice B) is pain that arises from the skin or tissues just beneath it. Precipitating pain (Choice D) refers to pain that is triggered by specific actions or events, not the characteristic described in the question.

3. What does preload refer to?

• A. The volume of blood entering the left side of the heart
• B. The volume of blood entering the right side of the heart
• C. The pressure in the venous system that the heart must overcome to pump the blood
• D. The pressure in the arterial system that the heart must overcome to pump the blood

Correct answer: B

Rationale: Preload refers to the volume of blood that enters the right side of the heart. This volume stretches the fibers in the heart before contraction. Preload is an essential factor in determining the force of ventricular contraction. Choices A, C, and D are incorrect. Choice A is incorrect because preload is specifically related to the volume of blood entering the right side of the heart. Choices C and D are incorrect as they refer to afterload, which is the pressure that the heart must overcome to pump blood out of the ventricles into the systemic or pulmonary circulation.

4. The nurse should wash from the ________________________ when washing a patient's eye area.

• A. outer canthus to the inner canthus
• B. inner canthus to the outer canthus
• C. internal nares to the external nares
• D. external nares to the internal nares

Correct answer: B

Rationale: When washing a patient's eye area, it is important to start from the inner canthus (closest to the nose) and move towards the outer canthus. This direction prevents any contaminants or debris from the outer area of the eye from moving towards the inner, more sensitive area. Choices C and D are incorrect as they pertain to the nasal passages (nares), which are not relevant when washing the eye area.

5. The healthcare professional has collected the following information on a patient: palpated blood pressure"?180 mm Hg; auscultated blood pressure"?170/100 mm Hg; apical pulse"?60 beats per minute; radial pulse"?70 beats per minute. What is the patient's pulse pressure?

• A. 10
• B. 70
• C. 80
• D. 100

Correct answer: B

Rationale: Pulse pressure is the numerical difference between the systolic and diastolic blood pressure readings. In this case, the systolic blood pressure is 170 mm Hg, and the diastolic blood pressure is 100 mm Hg. Therefore, the pulse pressure is calculated as 170 - 100 = 70 mm Hg. Pulse pressure reflects the stroke volume, the amount of blood ejected from the heart with each beat. Choices A, C, and D are incorrect because they do not accurately represent the difference between the systolic and diastolic blood pressure readings provided.

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