Nursing Elites

1. When assessing a client with a small bowel obstruction, what finding should a nurse expect?

• A. Significant abdominal distention
• B. Large bowel movements
• C. High-pitched bowel sounds
• D. Copious vomiting

Correct answer: C

Rationale: High-pitched bowel sounds are often heard early in a small bowel obstruction due to increased peristalsis as the bowel tries to overcome the blockage. Choices A, B, and D are incorrect. Abdominal distention is more commonly associated with large bowel obstructions, while large bowel movements and copious vomiting are not typical findings in small bowel obstructions.

2. A nurse is assessing a client who is at 31 weeks of gestation. Which of the following findings should the nurse identify as an indication of a potential prenatal complication?

• A. Periodic tingling of fingers
• B. Absence of clonus
• C. Leg cramps
• D. Blurred vision

Correct answer: D

Rationale: Blurred vision can be an indicator of serious conditions such as preeclampsia, which involves hypertension and can lead to significant maternal and fetal complications. Periodic tingling of fingers, absence of clonus, and leg cramps are common discomforts during pregnancy but are not typically associated with serious prenatal complications like preeclampsia. Therefore, the correct answer is D.

3. A healthcare professional is preparing to transfer a client from a chair to a bed. The client can bear partial weight and has upper body strength. Which device should the healthcare professional use?

• A. Hydraulic lift
• B. Stand-assist lift
• C. Wheelchair
• D. Mechanical lift

Correct answer: B

Rationale: A stand-assist lift is the appropriate device for transferring a client who can bear partial weight and has upper body strength. This device provides support for the client to stand up and be transferred safely. A hydraulic lift is more suitable for transferring clients who cannot bear weight. A wheelchair is used for mobility but not for transferring between a chair and a bed. A mechanical lift is typically used for transferring clients who are unable to bear weight or have limited mobility.

4. A client with a permanent spinal cord injury is scheduled for discharge. Which of the following client statements indicates that the client is coping effectively?

• A. “I would like to play wheelchair basketball. When I get stronger, I think I’ll look for a league.”
• B. “I’m glad I’ll only be in this wheelchair temporarily. I can’t wait to get back to running.”
• C. “I’m so upset that this happened to me. What did I do to deserve this, and why am I not getting better?”
• D. “I feel like I’ll never be able to do anything that I want to again. All I am is a burden to my family.”

Correct answer: A

Rationale: Choice A is the correct answer. This statement demonstrates effective coping as the client is showing acceptance of their disability and planning for the future with realistic goals. Choice B reflects denial of the permanent disability by stating that they will only be in a wheelchair temporarily. Choice C shows distress and a lack of acceptance by questioning why the injury happened and why they are not improving. Choice D indicates feelings of hopelessness and being a burden, which are not signs of effective coping.

5. A healthcare provider is among the first responders to a mass-casualty incident and does not know what type of personal protective equipment (PPE) is needed. Which of the following actions should the healthcare provider take?

• A. Use basic gloves and a mask.
• B. Choose the highest level of protection equipment available.
• C. Use only respiratory protection.
• D. Ask a colleague for advice.

Correct answer: B

Rationale: In situations where the type of hazard is unknown, the healthcare provider should choose the highest level of protection equipment available. This helps ensure adequate protection against any potential hazards that may be present. Using only basic gloves and a mask (Choice A) may not provide sufficient protection if the hazard is more severe. Opting for respiratory protection only (Choice C) may leave other areas of the body vulnerable to exposure. While asking a colleague for advice (Choice D) is good practice in general, in urgent situations like mass-casualty incidents with unknown hazards, it is crucial to prioritize immediate protection by selecting the highest level of PPE.

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