Nursing Elites

1. A client has been placed in isolation because he is diagnosed with a contagious illness. The nurse should be aware that:

• A. Linens from the client's bed should be double-bagged.
• B. Meals should be served on washable dishes.
• C. Extensive isolation rarely causes psychological problems.
• D. Paper trays and plastic utensils do not prevent disease transmission.

Correct answer: A

Rationale: Isolation techniques are used to prevent or limit the spread of infection. Special handling of articles and linens soiled by any body fluid is essential. Linens should be placed in impervious bags before being removed from the client's bedside to prevent exposure of personnel and contamination of the environment. Double-bagging is required if the outside of the bag becomes contaminated. This practice ensures that potentially infectious materials are properly contained and disposed of. Choices B, C, and D are incorrect because the focus in this scenario is on proper handling and disposal of soiled linens to prevent the spread of infection, not on serving meals, psychological effects of isolation, or the use of paper trays and plastic utensils.

2. Where do the vast majority of deaths resulting from unintentional poisoning occur?

• A. Infants
• B. Toddlers
• C. Teens
• D. Adults

Correct answer: B

Rationale: The correct answer is 'Toddlers.' Toddlers are at the highest risk of unintentional poisoning due to their natural curiosity, explorative behavior, and lack of awareness of potential dangers. Infants are typically closely monitored, teens are more aware of risks, and adults generally have better judgment and understanding of hazardous substances, making them less susceptible to unintentional poisoning. Therefore, toddlers, being inquisitive and unaware of risks, are the most vulnerable group in terms of unintentional poisoning incidents.

3. Which of the following statements by a client with gastroesophageal reflux disease (GERD) indicates adequate understanding?

• A. "I should eat right before bedtime."?
• B. "I should eat large meals."?
• C. "I should sit up after eating."?
• D. "I should lie flat after eating."?

Correct answer: C

Rationale: The correct statement for a client with GERD is, 'I should sit up after eating.' This helps prevent reflux by keeping the stomach contents down. Choice A is incorrect as eating right before bedtime can exacerbate GERD symptoms by increasing the likelihood of reflux during the night. Choice B is incorrect because consuming large meals can lead to increased stomach pressure and worsen reflux symptoms. Choice D is incorrect because lying flat after eating can promote reflux due to gravity assisting the flow of stomach contents into the esophagus, worsening GERD.

4. A client is complaining of difficulty walking secondary to a mass in the foot. The nurse should document this finding as:

• A. Plantar fasciitis.
• B. Hallux valgus.
• C. Hammertoe.
• D. Morton's neuroma.

Correct answer: D

Rationale: The correct answer is Morton's neuroma. Morton's neuroma is a small mass or tumor in a digital nerve of the foot, causing symptoms such as pain and difficulty walking. Hallux valgus is commonly known as a bunion and involves the deviation of the big toe towards the other toes. Hammertoe is a condition where one or more toes are bent in a claw-like position. Plantar fasciitis is characterized by pain and inflammation in the arch of the foot, not typically associated with a mass causing difficulty walking.

5. To assess a client's ankle ROM, which ROM exercises should the nurse have them perform?

• A. flexion, extension, hyperextension
• B. flexion, extension, abduction, adduction
• C. external rotation, internal rotation
• D. extension, flexion, inversion, eversion

Correct answer: D

Rationale: The correct answer is extension, flexion, inversion, and eversion. These exercises help assess the full range of motion of the ankles. Flexion and extension evaluate the bending and straightening movements of the ankle joint, respectively. Inversion and eversion assess the inward and outward movements of the foot at the ankle joint. Hyperextension, abduction, and adduction are not specific movements of the ankle joint, making choices A and B incorrect. External and internal rotation are movements more related to joints like the hip or shoulder, not the ankle, making choice C incorrect.

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