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What are the six levels of consciousness from the most to the least responsive level of consciousness? Number all six using 1 as the most conscious and 6 as the least conscious.
- A. Obtunded, Confused, Lethargic, Comatose, Stuporous, Alert
- B. Confused, Lethargic, Obtunded, Stuporous, Comatose, Alert
- C. Lethargic, Obtunded, Confused, Stuporous, Comatose, Alert
- D. Alert, Confused, Lethargic, Obtunded, Stuporous, Comatose
Correct Answer: D
Rationale: The correct order of the six levels of consciousness from most to least responsive is Alert, Confused, Lethargic, Obtunded, Stuporous, Comatose. Choice A is incorrect because it starts with Obtunded, which is less responsive than Alert. Choice B is incorrect as it doesn't follow the correct order. Choice C is incorrect as Lethargic is more responsive than Obtunded. Therefore, the correct answer is D.
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A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?
- A. A client who reports right-sided flank pain and is diaphoretic
- B. A client who has active bleeding from a puncture wound of the left groin area
- C. A client who has a raised red skin rash on his arms, neck, and face
- D. A client who reports shortness of breath and left neck and shoulder pain
Correct Answer: D
Rationale: The correct answer is D because shortness of breath with referred pain may indicate a serious condition, such as a cardiac event or pulmonary embolism, making this the highest priority. Option A, flank pain with diaphoresis, could suggest kidney-related issues but is not as immediately life-threatening as compromised breathing. Option B, active bleeding, though serious, can usually be controlled with proper interventions. Option C, a raised red skin rash, may indicate an allergic reaction but is not as urgent as respiratory distress with neck and shoulder pain.
Which of the following is the best way for a nurse to improve quality of care?
- A. Recognize that physicians are among the health-care professionals interested in improving quality of care.
- B. Work with patients and families to improve healthcare.
- C. Collaborate with other health-care professionals, patients, and their families.
- D. Recognize that physicians are among the numerous professionals in health care.
Correct Answer: C
Rationale: The best way for a nurse to improve the quality of care is by collaborating with other health-care professionals, patients, and their families. By working together with the healthcare team, patients, and families, nurses can ensure a holistic approach to care delivery, leading to better outcomes. Choices A and D are incorrect as they focus solely on physicians, while choice B, though important, does not fully encompass the collaborative aspect necessary for comprehensive care.
Your 54-year-old male HIV-positive patient has just expired. How should you care for this deceased patient?
- A. Bathe the patient, but it is still necessary to use standard precautions because the patient is deceased.
- B. Place the patient in a negative pressure isolated area of the morgue.
- C. Double shroud the patient to prevent the spread of infection.
- D. Bathe the patient using the same standard precautions you used when he was alive.
Correct Answer: D
Rationale: Even after a patient has expired, standard precautions should be maintained to prevent the spread of infection. Bathing the deceased patient should be done using the same standard precautions followed when the patient was alive. This includes using personal protective equipment and following proper infection control procedures. Choices A, B, and C are incorrect because standard precautions must still be adhered to even after the patient has passed away to ensure safety and prevent the transmission of infections.
Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient?
- A. Intravenous potassium supplementation
- B. Intravenous calcium supplementation
- C. Kidney dialysis
- D. Parenteral nutrition
Correct Answer: C
Rationale: The correct answer is C: Kidney dialysis. A blood potassium level of 9.2 mEq/L indicates severe hyperkalemia, which can be life-threatening. Kidney dialysis is the most appropriate intervention to rapidly lower potassium levels in this situation. Choice A, intravenous potassium supplementation, would worsen the hyperkalemia. Choice B, intravenous calcium supplementation, is not the primary intervention for hyperkalemia. Choice D, parenteral nutrition, is unrelated to treating hyperkalemia and would not address the immediate concern.
Which preventive measure can be employed to decrease the risk of compartment syndrome?
- A. The administration of a potassium-sparing diuretic for heart failure
- B. A bivalve cast for a skeletal fracture
- C. A cerebral diuretic to decrease intracranial pressure after a head injury
- D. A chest tube to restore normal intrathoracic pressure after a pneumothorax
Correct Answer: B
Rationale: The correct answer is B. A bivalve cast can help decrease the risk of compartment syndrome by providing space for swelling, thus preventing the build-up of pressure within the muscles. Choices A, C, and D are incorrect because they are not directly related to preventing compartment syndrome. Choice A is more focused on managing heart failure, choice C on reducing intracranial pressure, and choice D on restoring intrathoracic pressure after a pneumothorax, which are not relevant to preventing compartment syndrome.