Nursing Elites

1. As a nursing supervisor in a long-term care facility, you prioritize strict infection control prevention measures due to the understanding that the normal aging process weakens the body's defenses. Which theory of aging supports the necessity of strict infection control prevention measures?

• A. The Programmed Longevity Theory
• B. The Immunological Theory of Aging
• C. The Endocrine Theory
• D. The Rate of Living Theory

Correct answer: B

Rationale: The theory of aging that aligns with the need for strict infection control prevention measures is the Immunological Theory of Aging. This theory posits that aging leads to a decline in the body's immune defenses and a reduced ability of antibodies to protect against infections. The other theories do not directly address the impact of aging on the immune system. The Programmed Longevity Theory focuses on genetic changes affecting aging, the Endocrine Theory emphasizes hormonal changes, and the Rate of Living Theory relates longevity to the rate of oxygen metabolism.

2. A client with asthma is being admitted for breathing difficulties. His arterial blood gas results are pH 7.26, PCO2 49, PaO2 90, and HCO3- 21. Which of the following best describes this condition?

• A. Uncompensated respiratory acidosis
• B. Compensated respiratory alkalosis
• C. Uncompensated metabolic acidosis
• D. Compensated metabolic alkalosis

Correct answer: A

Rationale: In this case, the client's arterial blood gas results show a pH of 7.26 and a PCO2 of 49, both of which are abnormal. A pH below the normal range of 7.35-7.45 indicates acidosis. The elevated PCO2 of 49 mmHg suggests respiratory acidosis as the primary issue. The normal range for PCO2 is 35-45 mmHg, so a value of 49 indicates the retention of excess CO2, leading to acidosis. The low HCO3- level of 21 also supports the presence of metabolic acidosis; however, the primary abnormality is respiratory, making this an uncompensated respiratory acidosis. Therefore, the correct answer is 'Uncompensated respiratory acidosis.' Choice B, 'Compensated respiratory alkalosis,' is incorrect because the client's pH is acidic, not alkalotic. Additionally, there is no compensation occurring for the primary respiratory acidosis indicated by the elevated PCO2. Choice C, 'Uncompensated metabolic acidosis,' is incorrect because while the HCO3- level is low, the primary issue indicated by the elevated PCO2 is respiratory acidosis. Choice D, 'Compensated metabolic alkalosis,' is incorrect since the arterial blood gas results do not support a metabolic alkalosis. The low HCO3- level would typically be seen in metabolic acidosis, but in this case, the primary issue is respiratory acidosis.

3. A 3-year-old pediatric patient's mother would like to stay at the patient's bedside throughout the night as the patient seems calmer when she is present. What is the most caring and appropriate response?

• A. Reinforce visiting hours
• B. Allow her to stay for a short period beyond normal hours
• C. Allow her to stay throughout the night
• D. Offer to get bedding for a couch in the waiting room

Correct answer: C

Rationale: Allowing the mother to stay throughout the night is the most caring and appropriate response in this situation. Pediatric facilities often recognize the crucial role parents play in their child's care and are supportive of unlimited visitation. Allowing the mother to stay can help maintain the child's calmness and enhance the bond between the family and healthcare team. Reinforcing visiting hours (Choice A) may not address the specific needs of this situation where the child benefits from the mother's presence. Allowing her to stay for a short period beyond normal hours (Choice B) may not fully address the need for her continuous presence. Offering to get bedding for a couch in the waiting room (Choice D) may not be necessary if the mother can stay with her child in the patient's room.

4. Is it true that Hepatitis C virus (HCV) can be spread through hugging, sneezing, coughing, sharing eating utensils, and other forms of casual contact?

• A. True
• B. False
• C.
• D.

Correct answer: B

Rationale: False. HCV is not spread through casual contact such as hugging, sneezing, or sharing eating utensils. The correct modes of transmission for HCV include direct contact with human blood through blood transfusions, improperly sterilized needles and syringes, needle sharing, or occasionally through sexual contact. Therefore, the statement is false, making 'False' the correct answer. Choices A, C, and D are incorrect as they do not accurately reflect the mode of transmission of HCV.

5. Ruth is a 72-year-old patient who has been upset and crying all morning. When asked why she is upset, she turns toward the wall in silence. What collaborative process may be helpful in caring for this patient?

• A. Speak with the patient care technician
• B. Call the chaplain
• C. Call the social worker
• D. Call the patient's husband

Correct answer: A

Rationale: Collaborating with the patient care technician is an appropriate approach in this scenario. Patient care technicians and nurses' aides often provide direct care to patients, developing a closer relationship with them. Patients may feel more comfortable sharing their feelings with these caregivers compared to other healthcare professionals. In this situation, Ruth's distress appears more emotional than spiritual, making it more suitable to speak with someone directly involved in her care. Calling the chaplain (Choice B) might not directly address Ruth's immediate emotional needs as it could focus more on spiritual support. Involving the social worker (Choice C) could help address underlying emotional or social issues, but speaking with the patient care technician is a more direct and immediate step to assess and provide initial support. Calling the patient's husband (Choice D) may not address Ruth's immediate emotional distress and may not be appropriate without understanding the root cause of her upset.

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