Nursing Elites

1. Which of the following is NOT one of the major duties of the M6 practical nurse?

• A. Performing preventive, therapeutic, and emergency nursing care procedures
• B. Managing other paraprofessional personnel
• C. Managing ward or unit operations
• D. Implementing Level II through Level IV CSH operations

Correct answer: D

Rationale: The correct answer is D because implementing Level II through Level IV CSH operations is not a major duty of the M6 practical nurse. A practical nurse's major duties include performing preventive, therapeutic, and emergency nursing care procedures (Choice A), managing other paraprofessional personnel (Choice B), and managing ward or unit operations (Choice C). These duties are more aligned with the responsibilities of a practical nurse, emphasizing patient care and coordination within a healthcare setting.

2. In a routine sputum analysis, which of the following indicates proper nursing action before sputum collection?

• A. Secure a clean container
• B. Discard the container if the outside becomes soiled
• C. Rinse the client's mouth with water after collection
• D. Tell the client that 4 tablespoons of sputum are needed

Correct answer: A

Rationale: Corrected Rationale: Before sputum collection, it is crucial to use a clean container to prevent specimen contamination. This step is essential to ensure accurate test results and to avoid introducing external particles or bacteria into the sample. Choice B is incorrect because discarding the container if the outside becomes soiled is not a standard practice before collection. Choice C is incorrect as rinsing the client's mouth with Listerine after collection can introduce unnecessary substances into the specimen. Choice D is incorrect as the amount of sputum needed should be determined by the healthcare provider, not the client.

3. Which of the following is NOT one of the three basic areas of concern into which practical nurse management responsibilities can be categorized?

• A. Managing patients' legal affairs
• B. Overseeing neurological functions
• C. Managing work center operations
• D. Managing personnel

Correct answer: A

Rationale: The correct answer is A: 'Managing patients' legal affairs.' Practical nurse management responsibilities are typically categorized into managing work center operations, managing personnel, and overseeing patient care. Legal affairs management is not a standard responsibility for practical nurse management. Choice B is incorrect as it introduces information about the hypothalamus, which is unrelated to the question. Choice C and D are both common areas of concern in practical nurse management, involving the operations of the work center and managing personnel, respectively.

4. The nurse is caring for the client recovering from intestinal surgery. Which assessment finding would require immediate intervention?

• A. Presence of thin pink drainage in the Jackson Pratt
• B. Guarding when the nurse touches the abdomen
• C. Tenderness around the surgical site during palpation
• D. Complaints of chills and feeling feverish

Correct answer: D

Rationale: Complaints of chills and feeling feverish may indicate infection, which requires immediate intervention. This finding suggests a systemic response to infection, which can be life-threatening if not promptly addressed. Options A, B, and C are common postoperative findings and may not necessarily require immediate intervention unless accompanied by other concerning signs or symptoms.

5. The client diagnosed with thalassemia, a hereditary anemia, is to receive a transfusion of packed RBCs. The cross-match reveals the presence of antibodies that cannot be cross-matched. Which precaution should the nurse implement when initiating the transfusion?

• A. Start the transfusion at 10-15 mL per hour for 15-30 minutes
• B. Re-crossmatch the blood until the antibodies are identified
• C. Have the client sign a permit to receive uncrossmatched blood
• D. Have the unlicensed nursing assistant stay with the client

Correct answer: A

Rationale: Starting the transfusion slowly at 10-15 mL per hour for 15-30 minutes is the correct precaution to implement when the cross-match reveals the presence of antibodies that cannot be cross-matched. This allows the nurse to monitor for any adverse reactions due to the presence of antibodies. Re-crossmatching the blood until the antibodies are identified is not practical and may delay the transfusion, potentially compromising the patient's condition. Having the client sign a permit to receive uncrossmatched blood is not the best course of action as the focus should be on ensuring a safe transfusion. Having an unlicensed nursing assistant stay with the client does not address the specific precaution needed to manage a transfusion in the presence of antibodies.

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