Nursing Elites

1. A nurse demonstrates the procedure for bathing a newborn to a new mother. The next day, the nurse watches as the mother bathes the infant. The nurse determines that the mother is performing the procedure correctly if the mother performs which action?

• A. Uses a cotton-tipped swab to carefully clean inside the infant's nose
• B. Uncovers only the body part being washed
• C. Washes the diaper area first
• D. Washes the infant's chest first

Correct answer: B

Rationale: When bathing a newborn, it is crucial to follow a specific sequence for thorough cleaning and safety. The correct sequence includes starting with the eyes and face, then moving to the external ear, areas behind the ears, neck, hands, arms, legs, and finally the diaper area. Keeping the infant warm is essential, so only the body part being washed should be uncovered. Using a cotton-tipped swab to clean inside the infant's nose is not recommended due to the risk of injury if the infant moves suddenly. Washing the diaper area first is incorrect as it should be done towards the end of the bath to prevent contamination. Washing the infant's chest first is also incorrect as it deviates from the recommended bathing sequence for a newborn.

2. Following the change of shift report, when can or should the nurse's plan be altered or modified during the shift?

• A. halfway through the shift
• B. at the end of the shift before the nurse reports off
• C. when needs change
• D. after the top-priority tasks have been completed

Correct answer: C

Rationale: The correct answer is 'when needs change.' It is crucial for the nurse to remain adaptable and adjust the plan promptly when the patient's needs or condition change. Choice A, 'halfway through the shift,' may not align with the timing of when needs actually change, making it less optimal for plan modifications. Choice B, 'at the end of the shift before the nurse reports off,' is too late to address evolving needs effectively. Choice D, 'after the top-priority tasks have been completed,' limits the nurse's ability to respond promptly to changing priorities, as needs may shift before all top-priority tasks are finished.

3. A nurse assisting with data collection plans to assess tactile (vocal) fremitus. The nurse performs this by using which technique?

• A. Palpating for symmetric chest expansion
• B. Auscultating the breath sounds over the trachea and larynx
• C. Auscultating the breath sounds over the peripheral lung fields
• D. Palpating the thorax, comparing vibrations from side to side as the client repeats the word 'ninety-nine'

Correct answer: D

Rationale: To assess tactile (vocal) fremitus, the nurse palpates the thorax and compares vibrations from side to side as the client repeats the word 'ninety-nine.' This technique helps in evaluating the intensity and symmetry of vibrations felt. Palpating for symmetric chest expansion involves assessing the expansion of the chest during breathing by placing hands on the anterolateral wall. Auscultating the breath sounds over the trachea and larynx is done to assess bronchial breath sounds, while auscultating over the peripheral lung fields is used to assess vesicular breath sounds.

4. An assessment of the skull of a normal 10-month-old baby should identify which of the following?

• A. closure of the posterior fontanel.
• B. closure of the anterior fontanel.
• C. overlap of cranial bones.
• D. ossification of the sutures.

Correct answer: B

Rationale: The correct answer is the closure of the anterior fontanel. By 10 months of age, the anterior fontanel should be closed. The posterior fontanel should actually close by the age of 2 months, making choice A incorrect. Overlap of cranial bones is not a typical finding in a normal 10-month-old baby's skull, so choice C is incorrect. Ossification of the sutures is an ongoing process in skull development and should not be a definitive indicator at this age, making choice D incorrect.

5. A wrong committed by one person against another (or against the property of another) that might result in a civil trial is:

• A. a tort
• B. a crime
• C. a misdemeanor
• D. a felony

Correct answer: B

Rationale: A tort is a civil wrong committed by one person against another person (or against the property of another) that might result in civil trials. Unlike crimes, which are considered wrongs against the public, torts are personal wrongs. Misdemeanors are crimes punishable with fines or imprisonment for less than one year, whereas felonies are serious crimes punishable by imprisonment for more than one year in a State or Federal penitentiary. Therefore, the correct answer is a tort as it aligns with the definition of a civil wrong that leads to potential civil trials, distinguishing it from crimes, misdemeanors, and felonies.

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