Nursing Elites

1. What is a cavity containing pus surrounded by inflamed tissue?

• A. Cellulitis.
• B. An abscess.
• C. Extravasation.
• D. An adhesion.

Correct answer: B

Rationale: An abscess is defined as a cavity containing pus surrounded by inflamed tissue. Cellulitis is a bacterial skin infection causing redness and swelling, not a cavity. Extravasation is the leakage of fluid from a vessel into surrounding tissues, not a cavity. An adhesion is a band of scar-like tissue that binds two parts together, not a cavity containing pus and inflamed tissue.

2. Which insulin has the most rapid onset of action?

• A. Lente
• B. Lispro
• C. Ultralente
• D. Humulin N

Correct answer: B

Rationale: Lispro insulin has the most rapid onset of action among the options provided. It is a rapid-acting insulin analog that is designed to control postprandial hyperglycemia effectively. Lente insulin (Choice A) and Ultralente insulin (Choice C) are intermediate-acting insulins, which have a slower onset of action compared to Lispro. Humulin N (Choice D) is a neutral protamine Hagedorn (NPH) insulin, which is an intermediate-acting insulin, not rapid-acting like Lispro. Therefore, the correct choice is Lispro.

3. 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.

4. When reinforcing teaching and instructing the patient, which basic principle of teaching should you follow?

• A. Sequence the instruction from the least complex to the most complex.
• B. Assume that the patient knows little or nothing about the topic.
• C. Tell the patient to call their significant other so you can instruct them.
• D. Use medically oriented terms so the patient will be able to speak with the doctor.

Correct answer: A

Rationale: The correct principle of teaching to follow when reinforcing teaching and instructing the patient is to sequence the instruction from the least complex to the most complex. This approach facilitates learning by building upon simpler concepts before moving to more advanced ones. Choice B is incorrect because assuming the patient knows little or nothing about the topic may not always be accurate and can be patronizing. Choice C is incorrect as it does not focus on the direct teaching approach to the patient. Choice D is incorrect as using medically oriented terms may confuse the patient rather than facilitate understanding.

5. A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the following actions should the nurse take first?

• A. Discuss time management strategies with the nurses
• B. Provide coverage for the nurses' breaks
• C. Determine the reasons the nurses are not taking scheduled breaks
• D. Review policies for taking scheduled breaks

Correct answer: C

Rationale: The correct answer is to determine the reasons the nurses are not taking scheduled breaks. This action is crucial as it allows the charge nurse to understand the underlying causes for the behavior. By identifying the reasons, the nurse can then address the root of the issue effectively. Option A is incorrect because discussing time management strategies may not address the specific reasons for not taking breaks. Option B is incorrect as providing coverage for breaks does not address the underlying cause of the issue. Option D is also incorrect as reviewing policies should come after understanding the reasons for the behavior.

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