A nurse is caring for a client who is wearing anti-embolic stockings. Which of the following interventions should the nurse include in the plan of care?
- A. Determine if the stockings are binding
- B. Palpate the distal pulse to the cast
- C. Waits for 2 minutes between suctions
- D. Ask security to detain the client until the provider is notified
Correct Answer: A
Rationale: The correct answer is A: Determine if the stockings are binding. This is important because anti-embolic stockings should not be too tight as it can impede circulation, leading to complications. Palpating the distal pulse to the cast (B) is unrelated to anti-embolic stockings. Waiting for 2 minutes between suctions (C) is not relevant to the care of a client wearing anti-embolic stockings. Asking security to detain the client until the provider is notified (D) is inappropriate and violates the client's rights.
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While conducting a literature review for an evidence-based project, the nurse recognizes that which type of study represents the lowest level of evidence?
- A. Case reports
- B. Cohort studies
- C. Randomized control trials
- D. Cross-sectional studies
Correct Answer: A
Rationale: The correct answer is A: Case reports. Case reports represent the lowest level of evidence because they are anecdotal, describing observations of individual cases without control groups or systematic data collection. They lack generalizability and are subject to bias. Cohort studies (B), randomized control trials (C), and cross-sectional studies (D) are higher levels of evidence with more rigorous study designs and stronger ability to establish causation and relationships between variables. Cohort studies follow a group over time, RCTs involve random allocation of participants into groups, and cross-sectional studies provide a snapshot of a population at a specific point in time.
The nurse is performing an environmental assessment in an apartment building where many people have reported burning eyes, skin rash, stuffy nose, and sore throat. Which type of hazard does the nurse anticipate is present in the apartment building?
- A. Radon
- B. Mice
- C. Mold
- D. Lead
Correct Answer: C
Rationale: The correct answer is C: Mold. Mold can cause symptoms like burning eyes, skin rash, stuffy nose, and sore throat. Mold thrives in damp environments, common in buildings. Radon (A) is a colorless, odorless gas found in soil and can cause lung cancer. Mice (B) can carry diseases but do not typically cause these symptoms. Lead (D) exposure can lead to neurological issues, not the symptoms described. The other choices are not relevant to the symptoms reported.
A nurse is caring for a client who is comatose and has advance directives that indicate the client does not want life-sustaining measures. The client's family wants the client to have life sustaining measures. Which of the following actions should the nurse take?
- A. Arrange for an ethics committee meeting
- B. Balancing the bottle on the sterile basin while pouring the liquid
- C. Determine the client's current anxiety level
- D. Tell the child there will be discomfort during the catheter insertion
Correct Answer: A
Rationale: The correct answer is A: Arrange for an ethics committee meeting. In this scenario, the client has clear advance directives that they do not want life-sustaining measures. The nurse's primary responsibility is to advocate for the client's wishes, as outlined in their advance directives. By arranging an ethics committee meeting, the nurse can facilitate a discussion involving healthcare professionals, the client's family, and possibly legal experts to ensure that the client's wishes are respected while also addressing the concerns of the family. This process allows for a thorough review of the situation and consideration of all perspectives before making a final decision.
Choice B is incorrect because it is unrelated to the client's care preferences. Choice C is irrelevant as the client's anxiety level does not impact the decision about life-sustaining measures. Choice D is also unrelated to the client's advance directives and is not a priority in this situation.
Which of the following groups is pressuring clinicians the most to use evidence-based practice (EBP)?
- A. Administrators
- B. Insurance companies
- C. Nurses
- D. Physicians
Correct Answer: A
Rationale: The correct answer is A: Administrators. Administrators are pressuring clinicians the most to use evidence-based practice (EBP) as they are responsible for ensuring quality care, cost-effectiveness, and adherence to standards. They implement policies mandating EBP to improve patient outcomes and reduce healthcare costs. Nurses and physicians may advocate for EBP, but administrators hold the most influence due to their oversight of healthcare operations. Insurance companies focus more on reimbursement criteria rather than direct pressure for EBP implementation.
Public health nursing is distinguished from other specialties by adherence to eightprinciples. Which is one of the eight domains of public health nursing practice?
- A. Policy development and individual planning skills
- B. Individual dimensions of practice skills
- C. Financial planning and management skills
- D. Leadership and individual critical thinking skills
Correct Answer: A
Rationale: The correct answer is A: Policy development and individual planning skills. This domain is crucial in public health nursing as it involves advocating for policies that promote health and prevent disease within communities. Public health nurses need to understand how policies are developed and implemented to address population health issues effectively. Choices B, C, and D focus on individual aspects of practice and do not capture the population-based perspective of public health nursing. Therefore, they are incorrect.
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