Nursing Elites

1. A client with difficulty self-feeding due to rheumatoid arthritis should be referred to which member of the interprofessional care team to use adaptive devices?

• A. Social worker
• B. Certified nursing assistant
• C. Registered dietitian
• D. Occupational therapist

Correct answer: D

Rationale: The correct answer is D, Occupational therapist. Occupational therapists specialize in assisting clients with adaptive devices to enhance their ability to perform daily activities like self-feeding. They evaluate client needs and provide interventions to promote independence in activities of daily living. Choice A, Social worker, focuses on psychosocial support and community resources, not directly addressing the physical aspect of self-feeding difficulty. Choice B, Certified nursing assistant, is involved in direct patient care but lacks specialized training in adaptive devices. Choice C, Registered dietitian, primarily focuses on nutrition-related issues and may not have the expertise in adaptive devices and functional rehabilitation necessary for this client's self-feeding challenges.

2. A nurse is providing teaching to a newly licensed nurse about the care of a client who has MRSA. Which of the following statements by the newly licensed nurse indicates an understanding of teaching?

• A. I will place the client in a private room
• B. I will tell the client’s visitors to wear a mask when they are within 3 feet of the client
• C. I will remove my gown after leaving the client’s room
• D. I will wear an N95 respirator mask when caring for the client

Correct answer: A

Rationale: The correct answer is A: 'I will place the client in a private room.' Placing the client in a private room helps prevent the spread of MRSA, a contact precaution. Choice B is incorrect because visitors should be following standard precautions for MRSA, not just wearing a mask within a specific distance. Choice C is incorrect as the gown should be removed before exiting the client's room to prevent the spread of MRSA. Choice D is incorrect as an N95 respirator mask is not typically required for the care of a client with MRSA; standard precautions are usually sufficient.

3. While caring for a client who is postoperative and has refused to use an incentive spirometer following major abdominal surgery, what is the nurse's priority action?

• A. Request that a respiratory therapist discuss the technique for using the incentive spirometer
• B. Determine the reasons why the client is refusing to use the incentive spirometer
• C. Document the client's refusal to participate in health restorative activities
• D. Administer a pain medication to the client

Correct answer: B

Rationale: The nurse's priority is to determine the reasons why the client is refusing to use the incentive spirometer. By understanding the client's concerns or barriers, the nurse can address them appropriately. Requesting a respiratory therapist (Choice A) may be necessary later but is not the priority. Documenting the refusal (Choice C) is important but does not address the immediate need to assess and intervene. Administering pain medication (Choice D) without addressing the root cause of refusal is not appropriate and may mask the issue rather than resolve it.

4. The provider orders Lanoxin (digoxin) 0.125 mg PO and furosemide 40 mg every day. Which of these foods would the nurse reinforce for the client to eat at least daily?

• A. Spaghetti
• B. Watermelon
• C. Chicken
• D. Tomatoes

Correct answer: B

Rationale: The correct answer is B: Watermelon. Watermelon is high in potassium, which is important to eat daily when taking furosemide to prevent hypokalemia. Furosemide is a diuretic that can lead to potassium loss, so consuming potassium-rich foods like watermelon helps maintain adequate potassium levels. Spaghetti, chicken, and tomatoes are not as high in potassium and therefore not as beneficial in preventing hypokalemia related to furosemide use.

5. When performing nasotracheal suctioning for a client with a respiratory infection, what technique should the nurse use?

• A. Apply intermittent suction when withdrawing the catheter
• B. Suction continuously while inserting the catheter
• C. Suction intermittently while inserting the catheter
• D. Use a Yankauer suction device

Correct answer: A

Rationale: When performing nasotracheal suctioning for a client with a respiratory infection, the nurse should apply intermittent suction when withdrawing the catheter. This technique helps minimize mucosal damage and is considered best practice. Choice B, suctioning continuously while inserting the catheter, is incorrect as continuous suctioning can cause trauma to the airway. Choice C, suctioning intermittently while inserting the catheter, is also incorrect as it can increase the risk of hypoxia and mucosal damage. Choice D, using a Yankauer suction device, is not appropriate for nasotracheal suctioning as it is typically used for oral suctioning. Therefore, the correct technique is to apply intermittent suction when withdrawing the catheter to ensure effective and safe suctioning.

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