Nokea
A nurse at a school notices that several students have "blisters" on their bodies. Further investigation reveals that a terrorist incident has occurred, causing smallpox. If the chemical, biologic, radiologic, nuclear, and explosive (CBRNE) agent categories are used, this incident would be classified as:
- A. chemical.
- B. biologic.
- C. radiologic.
- D. nuclear.
Correct Answer: B
Rationale: The correct answer is B: biologic. Smallpox is a viral disease caused by the variola virus, making it a biological agent. The virus spreads from person to person through respiratory droplets or contact with infected bodily fluids. The term CBRNE encompasses various types of agents used in terrorism incidents. In this case, the incident involving smallpox falls under the biologic category due to its viral nature, as opposed to chemical (A), radiologic (C), or nuclear (D) agents. Chemical agents involve toxic substances, radiologic agents involve radiation, and nuclear agents involve nuclear materials. In summary, the smallpox incident is categorized as biologic due to the nature of the variola virus.
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An RN delegates to the unlicensed assistive personnel (UAP) the task of performing blood pressure checks for a group of patients on a nursing unit. The UAP accepts the task and is responsible for:
- A. delegating the task to another UAP if he or she does not have the time or skill to complete the task.
- B. keeping the RN informed of any abnormal blood pressure readings.
- C. calling the physician when the patient's vital signs are not within established parameters.
- D. informing the dietary department to initiate a low-sodium diet for patients who are hypertensive.
Correct Answer: B
Rationale: The correct answer is B because keeping the RN informed of any abnormal blood pressure readings is an essential part of the UAP's responsibility. This ensures that the RN is aware of any potential issues with the patients' health and can intervene if necessary. It is important for the UAP to communicate such vital information promptly to the RN, who has the clinical expertise to assess the situation and make appropriate decisions.
Choice A is incorrect because the UAP should not delegate tasks to another UAP without prior authorization from the RN. Choice C is incorrect because calling the physician directly is beyond the scope of practice for a UAP. Choice D is incorrect because initiating a low-sodium diet for hypertensive patients is a clinical decision that should be made by the RN or physician, not the UAP.
A new graduate from a master's entry program in nursing announces, "I just passed my clinical nurse leader certification examination." Certification as a clinical nurse leader:
- A. is granted by the state board of nursing.
- B. denotes minimum level of knowledge and skills to practice safely.
- C. allows independent nursing practice, often in primary care.
- D. recognizes achievement of advanced skills and knowledge.
Correct Answer: B
Rationale: The correct answer is B because obtaining the clinical nurse leader certification denotes that the individual has met the minimum level of knowledge and skills required to practice safely in that role. This certification does not grant independent practice authority as in choice C, nor is it granted by the state board of nursing as stated in choice A. Additionally, while the certification recognizes advanced skills and knowledge, it specifically signifies the minimum level needed for safe practice, making choice D incorrect.
A priority action for the nurse who works with culturally diverse clients is completion of a:
- A. sign language course.
- B. cultural self-assessment.
- C. cultural client assessment.
- D. continuing education course on how to speak Spanish.
Correct Answer: B
Rationale: The correct answer is B: cultural self-assessment. This is important as it helps the nurse understand their own beliefs, values, and biases, which can impact how they interact with culturally diverse clients. By being self-aware, the nurse can better recognize and address any potential cultural misunderstandings or conflicts.
A: Taking a sign language course is not the priority as not all culturally diverse clients are deaf or use sign language.
C: While cultural client assessment is important, it is secondary to the nurse understanding their own cultural biases first.
D: Taking a course on how to speak Spanish is helpful but may not address the broader cultural competence needed to work with diverse clients.
Which of the following situations would be appropriate for the supervisory level of initial direction and/or periodic inspection?
- A. Experienced RNs work together to provide care for a group of patients newly diagnosed with meningitis.
- B. The RN assigns the LPN tasks within her scope of practice and checks back during the shift to ensure the tasks are completed correctly.
- C. A new graduate nurse is assigned care to a male patient with a hematocrit of 11.0 g of hemoglobin per deciliter and is receiving a blood transfusion. The charge nurse checks on the patient status every 15 to 30 minutes and asks the graduate to explain "next steps."
- D. No supervision is necessary since both are registered nurses.
Correct Answer: B
Rationale: The correct answer is B because the scenario describes a situation appropriate for the supervisory level of initial direction and periodic inspection. The RN assigning tasks to the LPN within her scope of practice and checking back ensures tasks are completed correctly, aligning with the supervisory role. This level of oversight is necessary for safe and effective patient care.
Choice A is incorrect as experienced RNs working together do not require supervisory direction for caring for patients. Choice C involves the charge nurse providing frequent oversight to a new graduate nurse, which is more than just periodic inspection. Choice D is incorrect because regardless of both being registered nurses, supervision may still be necessary, especially when assigning tasks to a different level of healthcare provider like an LPN.
A comparison of nursing in the 1980s to nursing in the 1990s reveals that:
- A. in the 1990s nursing experienced a significant reduction occurred in preventable diseases caused by unsafe/unhealthy lifestyles.
- B. tuberculosis was the primary concern for nursing in the 1980s, whereas the AIDS epidemic emerged and was its focus during the 1990s.
- C. a decrease in ambulatory services in the 1980s prompted an increase in public health nurses in the 1990s.
- D. the demand for advanced practice nurses increased in the 1980s and the 1990s as a result of the economy and concern about the health of the nation.
Correct Answer: B
Rationale: The correct answer is B because it accurately reflects the shift in focus from tuberculosis in the 1980s to the emergence of the AIDS epidemic in the 1990s in the field of nursing. Tuberculosis was a major concern in the 1980s, and the AIDS epidemic became a primary focus in the 1990s.
Choice A is incorrect because it discusses preventable diseases caused by unsafe lifestyles, which is not directly related to the comparison of nursing between the two decades.
Choice C is incorrect because it mentions a decrease in ambulatory services in the 1980s leading to an increase in public health nurses in the 1990s, which is not supported by the historical context of nursing during those decades.
Choice D is incorrect because it suggests that the demand for advanced practice nurses increased in both the 1980s and the 1990s due to economic reasons and national health concerns, which is not specifically relevant to the comparison between nursing in the two decades.