Nursing Elites

1. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

2. In monitoring the patient in PACU, the nurse correctly identifies that checking the patient's vital signs is done every:

• A. 1 hour
• B. 5 minutes
• C. 15 minutes
• D. 30 minutes

Correct answer: A

Rationale: Correct Answer: A - Vital signs monitoring in the PACU (Post-Anesthesia Care Unit) is typically done every hour to closely monitor the patient's condition during the immediate postoperative period. This frequency allows the nurse to promptly identify any changes in the patient's vital signs and intervene as necessary. Choice B (5 minutes) is too frequent for routine vital signs monitoring in the PACU and may not allow for a comprehensive assessment of the patient's stability. Choice C (15 minutes) and Choice D (30 minutes) are also not in line with the standard practice of vital signs monitoring in the PACU, which is typically hourly.

3. Which food items should be avoided by a child with lactose intolerance?

• A. Popcorn, seeds, and any foods containing nuts.
• B. Milk, cheese, ice cream, and puddings.
• C. Wheat, rye, barley, and commercially baked goods.
• D. Eggs, ham, bacon, and canned meats.

Correct answer: B

Rationale: The correct answer is B: Milk, cheese, ice cream, and puddings should be avoided by a child with lactose intolerance because they contain lactose, which the child's body may have difficulty digesting. Option A is incorrect as popcorn, seeds, and foods containing nuts do not typically contain lactose. Option C lists wheat, rye, barley, and commercially baked goods, which are sources of gluten, not lactose. Option D includes eggs, ham, bacon, and canned meats, which are also not sources of lactose. Therefore, B is the most appropriate choice for a child with lactose intolerance.

4. Overdosage of medication or anesthetic can happen even with the aid of technology like infusion pumps, sphygmomanometer, and similar devices/machines. As a staff member, how can you improve the safety of using infusion pumps?

• A. Check the functionality of the pump before use
• B. Select the brand of infusion pump carefully
• C. Allow the technician to set the infusion pump before use
• D. Verify the flow rate against your calculation

Correct answer: D

Rationale: To enhance the safety of using infusion pumps, it is crucial to verify the flow rate against your calculation. This step ensures that the prescribed dosage is being delivered accurately, reducing the risk of medication errors. Checking the functionality of the pump before use (Choice A) is also important to ensure it is working properly. Allowing the technician to set the pump (Choice C) may not always guarantee the correct settings. Selecting the brand of infusion pump carefully (Choice B) is not directly related to the safe use of the pump.

5. What is the term for intestinal wounds associated with Crohn's disease that develop in different areas in the intestine, with normal tissue separating affected regions?

• A. Skip lesions
• B. Fistulas
• C. Fissures
• D. Loop ulcerations

Correct answer: A

Rationale: Skip lesions are typical characteristics of Crohn's disease, where patches of diseased intestine are interspersed with areas of healthy tissue. This is why option A is the correct answer. Option B, fistulas, are abnormal connections between two body parts, which is not what the question is describing. Option C, fissures, are small tears in the lining of the anus, which also do not fit the description in the question. Option D, loop ulcerations, is not a recognized medical term, making it an incorrect choice.

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