Nursing Elites

1. A confused client has been placed in physical restraints by order of the healthcare provider. Which task could be assigned to an unlicensed assistive personnel (UAP)?

• A. Assist the client with activities of daily living
• B. Monitor the client's physical safety
• C. Evaluate for basic comfort needs
• D. Document mental status and muscle strength

Correct answer: A

Rationale: The correct answer is A: 'Assist the client with activities of daily living.' Unlicensed assistive personnel (UAP) can help clients with activities of daily living, such as feeding, bathing, and dressing. This task is appropriate for UAP as it does not require professional judgment. Choices B, C, and D involve monitoring safety, evaluating needs, and documenting assessments, which require a licensed nurse's professional judgment and expertise.

2. The nurse is caring for a 4-year-old child with a greenstick fracture. In explaining this type of fracture to the parents, the best response by the nurse should be that

• A. A child's bone is more flexible and can be bent 45 degrees before breaking
• B. Bones of children are more porous than adults and often have incomplete breaks
• C. Compression of porous bones produces a buckle or torus type break
• D. Bone fragments often remain attached by a periosteal hinge

Correct answer: B

Rationale: The correct answer is B. Greenstick fractures are common in children because their bones are softer and more porous than adult bones, leading to incomplete breaks when force is applied. Choice A is incorrect as greenstick fractures are not due to bone flexibility but rather the porous nature of children's bones. Choice C is incorrect as it describes a buckle or torus type break, which is not characteristic of a greenstick fracture. Choice D is incorrect as greenstick fractures do not involve bone fragments remaining attached by a periosteal hinge.

3. The Healthy People initiative is a national agenda that aims to:

• A. Provide healthcare to all citizens
• B. Reduce health disparities and improve the health of all Americans
• C. Promote medical research
• D. Develop new healthcare technologies

Correct answer: B

Rationale: The Healthy People initiative is a national agenda that focuses on reducing health disparities and improving the health of all Americans. Choice A is incorrect because the initiative is more about improving health outcomes and access rather than providing healthcare to all citizens. Choice C is not the main goal of the initiative, which is more about public health goals than medical research. Choice D is also not the primary aim of the Healthy People initiative, as it is more focused on setting objectives to improve public health.

4. While caring for a client with infective endocarditis, the nurse must be alert for signs of pulmonary embolism. Which of the following assessment findings suggests this complication?

• A. Positive Homan's sign
• B. Fever and chills
• C. Dyspnea and cough
• D. Sensory impairment

Correct answer: C

Rationale: The correct answer is C: 'Dyspnea and cough.' Pulmonary embolism often presents with a sudden onset of dyspnea (difficulty breathing) and cough, which are due to the obstruction of blood flow in the pulmonary arteries. Choices A, B, and D are incorrect. Positive Homan's sign is associated with deep vein thrombosis, fever and chills are nonspecific symptoms commonly seen in infective endocarditis, and sensory impairment is not typically indicative of pulmonary embolism.

5. When providing nursing care to a client receiving oxygen therapy via a nasal cannula, which of the following interventions would be appropriate?

• A. Ensure that adequate mist is supplied
• B. Inspect the nares and ears for skin breakdown
• C. Lubricate the tips of the cannula before insertion
• D. Maintain sterile technique when handling the cannula

Correct answer: B

Rationale: The correct answer is to inspect the nares and ears for skin breakdown. This is important because the nasal cannula can cause skin breakdown due to prolonged use and friction. Ensuring that the skin is intact helps prevent complications. Choice A is incorrect as oxygen therapy via a nasal cannula does not involve mist. Choice C is incorrect as lubricating the tips of the cannula is not a standard practice and may lead to complications. Choice D is incorrect because while cleanliness is important, maintaining sterile technique is not necessary for handling a nasal cannula in this context.

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