Nursing Elites

1. How often should the intravenous tubing on total parenteral nutrition solutions be changed?

• A. every 24 hours
• B. every 36 hours
• C. every 48 hours
• D. every 72 hours

Correct answer: every 24 hours

Rationale: The correct answer is to change the intravenous tubing on total parenteral nutrition solutions every 24 hours. This frequency is necessary due to the high risk of bacterial growth associated with TPN solutions. Changing the tubing every 24 hours helps prevent contamination and bloodstream infections. Choices B, C, and D are incorrect because waiting longer intervals increases the risk of introducing harmful bacteria into the patient's system, leading to potentially severe complications.

2. The nurse is teaching parents of a newborn about feeding their infant. Which of the following instructions should the nurse include?

• A. Use the defrost setting on microwave ovens to warm bottles.
• B. When refrigerating formula, discard partially used bottles after 24 hours.
• C. When using formula concentrate, mix one part water and one part concentrate.
• D. When using powdered formula, mix two parts water and one part powder.

Correct answer: Use the defrost setting on microwave ovens to warm bottles.

Rationale: The correct answer is to use the defrost setting on microwave ovens to warm bottles. It is essential for parents to be cautious when warming bottles in a microwave oven to prevent superheating of the milk. Choosing the defrost setting and checking the formula temperature before giving it to the baby helps avoid burns. Discarding partially used bottles after 24 hours when refrigerating formula is crucial as it reduces the risk of harmful bacterial growth. Mixing formula concentrate with water in a 1:1 ratio of one part concentrate to one part water ensures proper dilution of the formula. On the other hand, powdered formula should be mixed following the package instructions, typically using two parts water to one part powder. This accurate mixing ratio provides the necessary balance of nutrients for the baby. Adding fresh formula to partially used bottles can introduce pathogens that may harm the infant, underscoring the importance of discarding partially used bottles and preparing formula correctly. Therefore, options B, C, and D are incorrect as they do not address the safe and proper ways to feed a newborn effectively.

3. What is one of the main goals of Healthy People 2010?

• A. reduction of health care costs
• B. elimination of health disparities
• C. investigation of substance abuse
• D. determination of an acceptable morbidity rate

Correct answer: elimination of health disparities

Rationale: The main goal of Healthy People 2010 is the elimination of health disparities among the U.S. population. This initiative outlines specific objectives to improve the overall health of Americans by addressing disparities in health outcomes. Choice A, reduction of health care costs, is not the primary goal of Healthy People 2010, although it may be a beneficial outcome. Choice C, investigation of substance abuse, is not a main goal of Healthy People 2010; while substance abuse may be a factor in health disparities, the primary focus is on broader disparities. Choice D, determination of an acceptable morbidity rate, is not the main focus of Healthy People 2010; instead, it aims to address health disparities in different population groups.

4. A nurse notes the presence of variable decelerations on the fetal heart rate monitor strip and suspects cord compression. The nurse should immediately perform which action?

• A. Insert a gloved finger into the mother's vagina to feel for cord compression
• B. Position the mother so that her hips are elevated
• C. Notify the registered nurse
• D. Perform a vaginal examination on the mother

Correct answer: Position the mother so that her hips are elevated

Rationale: When variable decelerations on the fetal heart rate monitor strip suggest cord compression, the immediate action the nurse should take is to reposition the mother to alleviate the compression. Elevating the mother's hips or changing her position can help shift the fetal presenting part and relieve pressure on the cord. This action aims to improve or resolve the variable decelerations. Contacting the registered nurse may be necessary, but it is not the immediate action required in this situation. Performing a vaginal examination is contraindicated due to the potential risk of further compromising blood flow through the umbilical cord. Inserting a gloved finger into the mother's vagina to feel for the cord is also not recommended as it poses a similar risk of exacerbating the situation.

5. A 17-year-old female was raped by a young man in her neighborhood. She is in the Emergency Department for evaluation and tests. After the procedure is completed, a rape crisis counselor (nurse specialist) talks to the client in a conference room regarding the rape. Implementing counseling by the nurse specialist for the raped victim represents:

• A. assessment.
• B. crisis intervention.
• C. empathetic concern.
• D. unwarranted intrusion

Correct answer: crisis intervention.

Rationale: Crisis intervention is the correct choice. Counseling by a nurse specialist after a traumatic event like rape falls under the Crisis Intervention Model. This approach aims to provide immediate support to individuals facing a crisis to enhance coping mechanisms. In this scenario, the nurse specialist is offering specialized care tailored to rape victims, helping the client navigate through the emotional aftermath of the traumatic experience. Choices A, C, and D are incorrect: A is not the correct answer as the nurse specialist is providing emotional support rather than conducting an assessment; C, while important, does not fully capture the specialized intervention being provided; and D is inaccurate as the nurse specialist's intervention is warranted and essential for the victim's well-being.

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