Nursing Elites

1. Who among the following individuals wrote a medical code of ethics?

• A. Hammurabi
• B. Thomas Percival
• C. Hippocrates
• D. All of the above

Correct answer: D

Rationale: All of the above individuals contributed to the development of medical ethics. Hammurabi created the earliest known code around 2500 BC. Hippocrates, known for the principle 'Do no harm,' emphasized ethical practices in medicine. Thomas Percival, a physician interested in sociological medicine, authored a Code of Medical Ethics in 1803, which influenced modern medical ethics. Therefore, the correct answer is 'All of the above.' Choices A, B, and C are incorrect because each of them individually wrote a medical code of ethics, making 'All of the above' the most inclusive and accurate answer.

2. At a community health fair, the blood pressure of a 62-year-old client is 160/96 mmHg. The client states, "My blood pressure is usually much lower."? The nurse should tell the client to:

• A. Go get a blood pressure check within the next 15 minutes
• B. Check blood pressure again in two (2) months
• C. See the healthcare provider immediately
• D. Visit the healthcare provider within one (1) week for a BP check

Correct answer: A

Rationale: The blood pressure reading of 160/96 mmHg is moderately high, indicating hypertension. Given that the client mentions their blood pressure is usually lower, there is concern for acute complications like a stroke. Therefore, an immediate reassessment of the blood pressure within the next 15 minutes is warranted to confirm the reading and take appropriate actions if necessary. Waiting for two months (Choice B) or a week (Choice D) could pose risks of delaying intervention. Seeing the healthcare provider immediately (Choice C) is a good option, but in this case, the urgency is not as high as to require immediate attention at the healthcare provider's office.

3. The key to the prevention of a pandemic influenza is:

• A. Early detection
• B. Early antibiotic treatment
• C. Vaccination of at-risk populations
• D. Isolation of suspected cases

Correct answer: A

Rationale: The key to preventing a pandemic influenza is early detection. Detecting influenza cases early allows for timely public health responses to limit the spread of the virus. Early detection helps in implementing measures such as isolation, treatment, and vaccination to prevent the development of a full-blown pandemic. Antibiotics are not effective against influenza viruses, so early antibiotic treatment is not the key to prevention. While vaccination of at-risk populations is important in controlling the spread of influenza, early detection is crucial as it allows for timely implementation of vaccination strategies. Isolation of suspected cases is a containment measure rather than a prevention strategy; the key to prevention lies in early detection to stop the spread before it becomes a pandemic.

4. Which of the following interventions is necessary before insertion of an arterial line into the radial artery?

• A. Ensure that the client does not need surgery
• B. Assess the client's grip strength
• C. Perform an Allen test
• D. Check a serum potassium level

Correct answer: C

Rationale: Before inserting an arterial line into the radial artery, it is crucial to perform an Allen test. The Allen test assesses the collateral circulation to the hand by compressing both the radial and ulnar arteries. By occluding the radial artery and releasing the ulnar artery, the nurse can check if the ulnar artery can adequately supply blood to the hand if the radial artery is cannulated. This step ensures that there is adequate circulation to the hand post-insertion of the arterial line. Choice A, ensuring that the client does not need surgery, is not directly related to the insertion of an arterial line and is not a necessary step before the procedure. Choice B, assessing grip strength, is not specific to the vascular status of the hand and does not provide information about the adequacy of collateral circulation. Choice D, checking a serum potassium level, is unrelated to the assessment of radial artery patency and collateral circulation, which are the primary concerns before arterial line insertion.

5. Jaime has a diagnosis of schizophrenia with negative symptoms. In planning care for the client, Nurse Brienne would anticipate a problem with:

• A. Auditory hallucinations
• B. Bizarre behaviors
• C. Ideas of reference
• D. Motivation for activities

Correct answer: D

Rationale: In clients with negative symptoms of schizophrenia, such as Jaime, a common problem is avolition, which is the lack of motivation for activities. These 'negative' symptoms are characterized by inexpressive faces, blank looks, monotone speech, few gestures, and a seeming lack of interest in the world. Patients may also experience an inability to feel pleasure or act spontaneously. It is crucial to differentiate between the lack of expression and lack of feeling, as well as between lack of will and lack of activity. Auditory hallucinations (choice A) are positive symptoms, not typically associated with negative symptoms of schizophrenia. Bizarre behaviors (choice B) are more aligned with positive symptoms like disorganized behavior. Ideas of reference (choice C) involve incorrectly interpreting casual incidents and external events as having direct reference to oneself, which is not directly related to motivation for activities seen in negative symptoms.

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