Nursing Elites

1. A client is in the emergency room in critical condition and hypotensive. Her spouse is distraught. What is the priority nursing action?

• A. Maintain the client's blood pressure
• B. Call a chaplain
• C. Provide the spouse a chair
• D. Ask the client's spouse to explain what happened

Correct answer: A

Rationale:

2. While completing a health history the client reports experiencing blurring of vision in both eyes without associated pain. What condition does the nurse suspect?

• A. Macular degeneration
• B. Cataract
• C. Retinal detachment
• D. Glaucoma

Correct answer: B

Rationale: Cataracts can cause blurring of vision in both eyes without associated pain.

3. A client has sustained an open fracture. How can the nurse best prevent osteomyelitis in this client?

• A. Administer pain medication
• B. Use proper hand hygiene and strict infection control
• C. Delegate all client personal care to specific unlicensed assistive personnel
• D. Plate the client in contact precautions

Correct answer: B

Rationale:

4. Which nonpharmacological intervention does not help reduce edema?

• A. Heat therapy
• B. Passive range of motion (PROM)
• C. Elevation of the extremity
• D. Cold therapy

Correct answer: A

Rationale: The correct answer is A: Heat therapy. Heat therapy can vasodilate blood vessels, increasing blood flow to the area and potentially exacerbating edema. Passive range of motion (PROM), elevation of the extremity, and cold therapy are all beneficial interventions for reducing edema. PROM helps with circulation, elevation assists in reducing fluid accumulation, and cold therapy can help constrict blood vessels and decrease swelling.

5. A goal for a client with impaired mobility is to prevent skin breakdown. What nursing intervention would best help the client meet this goal?

• A. Assist the client to orthopneic position
• B. Offer the client a bedpan for toileting
• C. Offer a protein-rich diet
• D. Turn the client every 2 hours

Correct answer: D

Rationale:

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