Nursing Elites

1. A Hispanic client brings her father to the clinic because he is becoming more forgetful. He is diagnosed with Alzheimer's disease. The woman tells the nurse that she wants to try ginkgo biloba for her father before using prescription medications. Which of the following is an appropriate response by the nurse?

• A. "It is wiser to start with a prescription."?
• B. "That herb may not be effective for your father."?
• C. "You can't expect an herb to cure Alzheimer's."?
• D. "I will let the physician know of your wishes."?

Correct answer: D

Rationale: The appropriate response is to acknowledge the client's wishes and communicate them to the physician for consideration. It is important to be culturally sensitive and respect the client's preferences. Ginkgo biloba has shown some benefits in treating dementia, so it is essential to involve the healthcare provider in the decision-making process. Choices A, B, and C are dismissive and fail to consider the client's perspective and cultural beliefs. It is crucial for healthcare professionals to engage in open communication and collaboration with clients to provide patient-centered care.

2. Which type of diet should the nurse provide to help a client who has major burns maintain a positive nitrogen balance?

• A. high protein
• B. high carbohydrate
• C. low carbohydrate
• D. low protein

Correct answer: A

Rationale: Clients with major burns are in a hypermetabolic state, leading to increased protein catabolism. Therefore, a high-protein diet is essential to help them maintain a positive nitrogen balance and support wound healing. High carbohydrate diets do not directly contribute to achieving a positive nitrogen balance, making choice B incorrect. Similarly, low carbohydrate diets are not recommended for clients with major burns as carbohydrates provide essential energy needed for healing. Low protein diets are contraindicated for clients with major burns as they require higher protein intake to support tissue repair and prevent further breakdown.

3. Why would a nurse employed at a hospital be asked by a nurse manager to review the organizational chart?

• A. To be aware of the geographic area that the organization serves
• B. To be familiar with the organization's line of authority
• C. To understand the organization's reason for existence
• D. To be familiar with the beliefs and values of the organization

Correct answer: B

Rationale: The correct answer is 'To be familiar with the organization's line of authority.' Organizational charts provide a visual representation of the chain of command, reporting relationships, and structure within an organization. This helps employees understand who they report to, who reports to them, and the overall hierarchy. Choice A is incorrect because understanding the geographic area served is more about the organization's scope, not depicted in an organizational chart. Choice C is incorrect as it relates to the organization's reason for existence, usually found in its mission statement. Choice D is incorrect as beliefs and values are linked to the organization's culture, not typically shown in an organizational chart.

4. A nurse provides instructions to a mother about crib safety for her infant. Which statement by the mother indicates a need for further instructions?

• A. ''Wood surfaces on the crib need to be free of splinters and cracks.''
• B. ''I need to keep large toys out of the crib.''
• C. ''The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body.''
• D. ''The drop side needs to be impossible for my infant to release.''

Correct answer: C

Rationale: The correct answer is, ''The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body.'' This statement indicates a need for further instructions as the distance between the slats should be no more than 2⅜ inches to prevent entrapment of the infant's head and body, not 4 inches. Allowing a larger gap can pose a risk of entrapment or injury to the infant. Keeping large toys out of the crib is essential to prevent the infant from using them to climb out, which could result in serious injuries. Ensuring the drop side of the crib is impossible for the infant to release is crucial to prevent falls and injuries. Additionally, maintaining wood surfaces on the crib free of splinters, cracks, and lead-based paint is vital for the infant's safety and well-being.

5. When placing a Foley catheter in a female client, what is the correct order of steps?

• A. E, A, F, B, C, G, D
• B. A, E, B, F, G, D, C
• C. A, E, F, B, C, G, D
• D. E, A, F, B, C, G, D

Correct answer: D

Rationale: The correct order for placing a Foley catheter in a female client is as follows: E. Place the client in a supine position with flexed knees, A. Prepare the sterile field, F. Place lubricant on the catheter, B. Separate labia with the non-dominant hand, C. Clean the urinary meatus using cleansing solutions and forceps, G. Place the catheter in the meatus with the dominant (sterile) hand, and D. Inflate the catheter balloon. This sequence ensures proper hygiene, patient comfort, and reduces the risk of infection. Incorrect sequences could compromise sterility, cause discomfort, and increase the risk of infection. Therefore, the correct answer is E, A, F, B, C, G, D.

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