Nursing Elites

1. A charge nurse is observing a newly licensed nurse apply sterile gloves. Which of the following actions by the newly licensed nurse demonstrates sterile technique?

• A. Putting a glove on the dominant hand first
• B. Removing gloves and putting on a sterile gown first
• C. Putting sterile gloves last
• D. Applying gloves without touching outer surfaces

Correct answer: A

Rationale: The correct answer is A. Putting the glove on the dominant hand first is a key step in maintaining sterile technique as it reduces the risk of contamination. By covering the dominant hand first, the nurse minimizes the risk of contaminating the other hand during the glove application process. Choices B, C, and D are incorrect. Choice B introduces the concept of a sterile gown, which is not relevant to the question about applying sterile gloves. Choice C is incorrect as putting sterile gloves last does not follow the correct sequence of steps in maintaining sterility. Choice D, while important, is not as critical as covering the dominant hand first when applying sterile gloves.

2. What is the key management strategy for diabetic ketoacidosis (DKA)?

• A. Administer insulin
• B. Monitor blood glucose
• C. Administer IV fluids
• D. All of the above

Correct answer: D

Rationale: The key management strategy for diabetic ketoacidosis (DKA) involves a comprehensive approach that includes administering insulin to lower blood glucose levels, monitoring blood glucose levels to ensure they are within the target range, and administering IV fluids to correct dehydration and electrolyte imbalances. Choosing 'All of the above' as the correct answer is the most appropriate because all three interventions are essential components of DKA management. Administering insulin alone without addressing fluid status and monitoring blood glucose could lead to complications. Similarly, solely focusing on IV fluids or blood glucose monitoring without insulin administration would not effectively manage DKA.

3. A nurse is caring for a client who is in the early stages of hypovolemic shock. Which of the following findings should the nurse expect?

• A. Heart rate 60/min
• B. Increased urinary output
• C. Increased respiratory rate
• D. Hypothermia

Correct answer: C

Rationale: In the early stages of hypovolemic shock, the body initiates compensatory mechanisms to maintain perfusion. One of these mechanisms is an increased respiratory rate to improve oxygen delivery. This helps to offset the decreased circulating blood volume. A heart rate of 60/min (choice A) is not expected in hypovolemic shock; instead, tachycardia is a common finding due to the body's attempt to maintain cardiac output. Increased urinary output (choice B) is not typically seen in hypovolemic shock as the body tries to conserve fluid. Hypothermia (choice D) is usually a late sign of shock when the body's compensatory mechanisms are failing, and perfusion is severely compromised.

4. A nurse is reviewing the medical record of a client with dementia. Which of the following findings should the nurse address first?

• A. Psychosocial stressors
• B. Restlessness and agitation
• C. Frequent wandering at night
• D. Urinary incontinence

Correct answer: B

Rationale: In clients with dementia, restlessness and agitation are important symptoms that the nurse should address first. These symptoms can indicate underlying issues such as pain, discomfort, or unmet needs, and addressing them promptly can prevent complications. Psychosocial stressors may contribute to the client's condition but should not be the initial priority. Frequent wandering at night and urinary incontinence are also common in dementia but do not pose immediate risks compared to restlessness and agitation.

5. A healthcare professional is preparing to discharge a client who is immunocompromised. Which of the following vaccines should the professional plan to administer?

• A. Varicella
• B. Influenza
• C. Hepatitis B
• D. Pneumococcal polysaccharide

Correct answer: D

Rationale: Immunocompromised clients have weakened immune systems, making them more susceptible to infections. The pneumococcal polysaccharide vaccine is recommended for these individuals to help prevent pneumococcal infections, which can be severe and life-threatening. Varicella, Influenza, and Hepatitis B vaccines are not specifically indicated for immunocompromised clients. Varicella contains a live virus that can cause infections in immunocompromised individuals. Influenza is generally recommended for all individuals over 6 months of age but does not have the same priority as the pneumococcal vaccine for immunocompromised clients. Hepatitis B vaccine is crucial for preventing Hepatitis B infection but is not directly related to the increased infection risk faced by immunocompromised clients.

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