Nursing Elites

1. A nurse has been ordered to set up Buck's traction on a patient's lower extremity due to a femur fracture. Which of the following applies to Buck's traction?

• A. A weight greater than 10 lbs. should be used.
• B. The line of pull is upward at an angle.
• C. The line of pull is straight
• D. A weight greater than 20 lbs. should be used.

Correct answer: C

Rationale: The correct answer is that the line of pull is straight for Buck's traction. This type of traction is applied to maintain alignment and immobilization of fractures, typically involving the lower extremities. A straight line of pull helps to provide the necessary countertraction to keep the fractured bone in proper alignment. Choices A and D are incorrect because Buck's traction commonly uses a weight range between 5-10 lbs, and using a weight greater than 10 or 20 lbs would not be appropriate or safe. Choice B is incorrect as well since the line of pull for Buck's traction is straight, not upward at an angle.

2. Which of the following diseases or conditions is least likely to be associated with an increased potential for bleeding?

• A. metastatic liver cancer
• B. gram-negative septicemia
• C. pernicious anemia
• D. iron-deficiency anemia

Correct answer: C

Rationale: Pernicious anemia is least likely to be associated with an increased potential for bleeding compared to the other conditions listed. Pernicious anemia is a condition resulting from vitamin B12 deficiency due to the absence of intrinsic factor, necessary for B12 absorption. While pernicious anemia can lead to neurological issues, it is not directly linked to an increased risk of bleeding. Metastatic liver cancer can cause liver dysfunction leading to coagulopathy, gram-negative septicemia can result in disseminated intravascular coagulation (DIC), and iron-deficiency anemia can lead to microcytic hypochromic red blood cells, increasing the risk of bleeding. Therefore, pernicious anemia is the least likely to be associated with an increased potential for bleeding out of the options provided.

3. Which electrolyte imbalance would be the nurse's priority concern in the burn client?

• A. Hypernatremia
• B. Hyperkalemia
• C. Hypoalbuminemia
• D. Hypermagnesemia

Correct answer: B

Rationale: The correct answer is hyperkalemia. In a burn client, the nurse's priority concern is hyperkalemia due to cell lysis, which releases potassium into the bloodstream. This can lead to dangerous levels of potassium in the blood. Hypernatremia (Choice A) is less likely in burn clients. Hypoalbuminemia (Choice C) can occur but is not the priority in the immediate management of a burn client. Hypermagnesemia (Choice D) is not typically associated with burn injuries.

4. Teaching the client with gonorrhea how to prevent reinfection and further spread is an example of

• A. primary prevention
• B. secondary prevention
• C. tertiary prevention
• D. primary health care prevention

Correct answer: B

Rationale: The correct answer is B: secondary prevention. This type of prevention focuses on reducing the impact of a disease by early detection and treatment. In the case of gonorrhea, teaching the client how to prevent reinfection and further spread falls under secondary prevention because it aims to reduce the prevalence and morbidity of the disease. Choice A (primary prevention) involves measures to prevent the disease from occurring in the first place, such as vaccination. Choice C (tertiary prevention) focuses on managing the long-term consequences of a disease to prevent complications. Choice D (primary health care prevention) is not a recognized term in prevention strategies.

5. A 20-year-old obese female client is preparing to have gastric bypass surgery for weight loss. She says to the nurse, "I need this surgery because nothing else I have done has helped me to lose weight."? Which response by the nurse is most appropriate?

• A. "If you eat less, you can save some money."?
• B. "Exercise is a healthier way to lose weight."?
• C. "You should try the Atkins diet first."?
• D. "I respect your decision to choose surgery."?

Correct answer: D

Rationale: The most appropriate response by the nurse is to show respect and empathy towards the client's decision. Option D acknowledges the client's autonomy and decision-making process, fostering a therapeutic relationship. Options A, B, and C are insensitive and unprofessional. Option A implies a financial incentive for weight loss, which can be perceived as disrespectful and trivializing the client's concerns. Option B suggests an alternative method without considering the client's reasons for choosing surgery, potentially invalidating her experiences. Option C recommends a specific diet without addressing the client's concerns or choices, neglecting her autonomy in decision-making.

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