Nursing Elites

1. A client has AIDS. Which of these findings indicate possible infection?

• A. Respirations; 22 breaths per minute
• B. Client ambulates 20 feet
• C. Purulent drainage
• D. Oxygen saturation; 97% on room air

Correct answer: C

Rationale:

2. What is a classic symptom assessed in clients with lupus?

• A. Butterfly rash
• B. Chvostek's sign
• C. Ovid's sign
• D. Heberden's nodes

Correct answer: A

Rationale:

3. A client is bedridden and appears to be frail and malnourished. Which nursing interventions will increase the risk of pressure injury?

• A. Applying moisturizer to dry areas of the skin
• B. Massaging the client's reddened shoulders and heels
• C. Cleansing the skin routinely after soiling occurs
• D. Using a Hoyer lift for all transfers

Correct answer: B

Rationale:

4. The client moves both crutches forward, with weight on the unaffected leg, and then moves the unaffected leg forward, shifting weight onto it. Which of the following gaits is being utilized?

• A. Two-point gait
• B. Three-point gait
• C. Four-point gait
• D. Unaffected gait

Correct answer: B

Rationale: The correct answer is B, Three-point gait. In a three-point gait, one leg is non-weight bearing, as described in the scenario where the client shifts weight onto the unaffected leg. Choices A, C, and D are incorrect. A two-point gait involves partial weight-bearing on both legs, a four-point gait involves weight-bearing on both legs, and 'Unaffected gait' is not a recognized term in gait patterns.

5. The client complains of fatigue and joint pain and reports that they are unable to walk due to pain in the knees. What is the most appropriate statement by the nurse?

• A. "You just have arthritis and should take some ibuprofen."?
• B. "You should avoid walking. This might be osteoporosis."?
• C. "Please tell me more about when your pain started."?
• D. "You need to lose weight or the pain won't go away."?

Correct answer: C

Rationale:

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