Nursing Elites

1. Pulling is easier than pushing. So pulling a client rather than pushing them has which of the following advantages?

• A. reduces workload
• B. decreases opposition from gravity
• C. maintains stability
• D. prevents muscle strain

Correct answer: A

Rationale: When pulling a client, you work with the gravitational force instead of opposing it, which reduces the workload on your muscles. Choosing to pull a client minimizes the effort required compared to pushing. Choice B is incorrect because the force of gravity remains constant regardless of pushing or pulling. Choice C is irrelevant as stability is not directly related to the advantage of pulling over pushing. Choice D is inaccurate because pulling can still strain muscles if not executed correctly, but it generally reduces the overall workload in comparison to pushing.

2. When planning task assignments for five clients on the skilled nursing unit in a long-term care facility, which task should a licensed practical nurse (LPN) assign to another LPN?

• A. Bathing a client who is confused and requires assistance with a shower
• B. Administering regular insulin in accordance with a sliding-dosage scale every 4 hours to a client with diabetes mellitus
• C. Assisting a client requiring a bed bath and frequent ambulation with a cane
• D. Transporting a client who must be accompanied to physical therapy twice during the shift

Correct answer: B

Rationale: When assigning tasks, the nurse must consider the skills and educational level of the nursing staff. The nursing assistant may be assigned tasks like caring for a confused client, assisting with a shower or a bed bath, ambulating a client with a cane, and accompanying a client to physical therapy. The LPN is educated to administer medications like regular insulin in accordance with a sliding scale. This task requires a higher level of training and knowledge than the tasks that can be delegated to a nursing assistant. Administering insulin involves assessing blood glucose levels, calculating dosages, and understanding the effects of insulin therapy on the client's condition. Therefore, the correct answer is administering regular insulin to a client with diabetes mellitus. Choices A, C, and D involve tasks that are within the scope of practice of a nursing assistant, not an LPN.

3. The nurse has completed client teaching about introducing solid foods to an infant. To evaluate teaching, the nurse asks the mother to identify an appropriate first solid food. Which of the following is an appropriate response?

• A. pureed canned squash
• B. pureed apples
• C. yogurt
• D. infant rice cereal

Correct answer: D

Rationale: The correct answer is infant rice cereal. Single-grain infant cereals are recommended as the first solid food because they are easily digestible and have added iron content. Choice C, yogurt, is incorrect because yogurt is a milk product and should be delayed until the child is 12 months old due to the risk of milk allergy. Choices A and B are incorrect because fruits and vegetables are typically introduced after cereals to help the infant get accustomed to solid foods gradually.

4. How should an infant be secured in a car?

• A. To hold the infant while sitting in the middle of the back seat of the car
• B. To place the infant in the front seat in a rear-facing infant safety seat if the car has passenger-side air bags
• C. To place the infant in a booster seat in the front seat with the shoulder and lap belts secured around the infant
• D. To secure the infant in the middle of the back seat in a rear-facing infant safety seat

Correct answer: D

Rationale: The recommended way to secure an infant in a car is to place them in the middle of the back seat in a rear-facing infant safety seat. Option A is incorrect because infants should never be held while in a moving vehicle due to safety concerns. Option B is incorrect because placing an infant in the front seat with a rear-facing safety seat can be risky if the car has passenger-side airbags. Option C is incorrect as booster seats are not suitable for infants. Therefore, the correct choice is to secure the infant in the middle of the back seat in a rear-facing infant safety seat.

5. A nurse is planning client assignments for the day. Which task should the nurse assign to the nursing assistant (unlicensed assistive personnel)?

• A. Recording the urinary output for a client with renal calculi whose urine must be strained
• B. Dressing change instructions for a client who had a mastectomy 2 days ago
• C. Reporting abnormal lab values to the health care provider for a client scheduled for a laparoscopic cholecystectomy
• D. Preprocedural teaching for a client scheduled for a cardiac stress test

Correct answer: A

Rationale: The nurse is legally responsible for client assignments and must assign tasks based on state nursing practice act guidelines and job descriptions provided by the employing agency. The nursing assistant is trained to measure, collect, and strain urine, making recording urinary output for a client with renal calculi a suitable task for the nursing assistant. This task falls within the nursing assistant's role description. Dressing change instructions for a client who had a mastectomy involve a higher level of skill and knowledge, beyond the scope of a nursing assistant. Reporting abnormal lab values to the health care provider for a client scheduled for a laparoscopic cholecystectomy requires interpretation and clinical judgment, which is typically not within the nursing assistant's role. Preprocedural teaching for a client scheduled for a cardiac stress test involves providing detailed information and education, which is usually the responsibility of a licensed nurse or other qualified healthcare provider.

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