Nursing Elites

1. A nurse is assigned to a manipulative client for 5 days and becomes aware of feelings of reluctance to interact with the client. What should the nurse do next?

• A. Discuss the feelings of reluctance with an objective peer or supervisor
• B. Limit contacts with the client to avoid reinforcement of the manipulative behavior
• C. Confront the client about the negative effects of behaviors on other clients and staff
• D. Develop a behavior modification plan that will promote more functional behavior

Correct answer: A

Rationale: It is important for the nurse to address their feelings of reluctance when dealing with a manipulative client by discussing them with an objective peer or supervisor. This action can provide valuable insight and support for managing the nurse-client relationship. Choice B should be avoided as limiting contacts with the client may not address the underlying issues and could potentially harm the therapeutic relationship. Choice C is confrontational and may escalate the situation rather than resolve it. Choice D, while important, should come after addressing the nurse's feelings and seeking support.

2. A nurse is providing care to a client who has an indwelling urinary catheter. Which of the following actions should the nurse take to prevent catheter-associated urinary tract infections (CAUTIs)?

• A. Irrigate the catheter with sterile water daily.
• B. Empty the catheter bag every 8 hours.
• C. Clean the perineal area with antiseptic solution daily.
• D. Secure the catheter to the client's thigh.

Correct answer: D

Rationale: Securing the catheter to the client's thigh is the correct action to prevent CAUTIs. By securing the catheter, movement is minimized, reducing the risk of introducing bacteria into the urinary tract. Choice A is incorrect because routine irrigation of the catheter is not recommended as it can increase the risk of infection. Choice B is incorrect as emptying the catheter bag every 8 hours is important for proper drainage but does not directly prevent CAUTIs. Choice C is incorrect because cleaning the perineal area with antiseptic solution does not address the main source of CAUTIs related to catheter care.

3. A client who had a stroke requires assistance with morning ADLs. Which of the following interprofessional team members should the nurse consult?

• A. Registered dietitian.
• B. Occupational therapist.
• C. Speech-language pathologist.
• D. Physical therapist.

Correct answer: B

Rationale: The correct answer is B, Occupational therapist. An occupational therapist specializes in assisting clients with daily living activities, making them crucial for a stroke patient requiring help with morning activities of daily living (ADLs). While a registered dietitian (A) may provide nutritional guidance, a speech-language pathologist (C) focuses on communication and swallowing disorders, and a physical therapist (D) primarily deals with mobility and physical rehabilitation. However, none of these professionals directly address the specific needs related to ADLs following a stroke as effectively as an occupational therapist.

4. While reviewing the medical records of a client with a pressure ulcer, a nurse should expect which of the following findings?

• A. Albumin level of 3 g/dL
• B. Hemoglobin level of 12 g/dL
• C. WBC count of 6,000/mm³
• D. Blood glucose level of 100 mg/dL

Correct answer: A

Rationale: An albumin level below 3.5 g/dL indicates protein deficiency, which can impair wound healing and contribute to pressure ulcer formation. Hemoglobin level and WBC count are not directly associated with pressure ulcers. Blood glucose level, while important for overall health, is not specifically linked to pressure ulcer development.

5. When providing a bath, in which order will the nurse clean the body, beginning with the first area?

• A. Face
• B. Eyes
• C. Perineum
• D. Back and buttocks

Correct answer: B

Rationale: The correct sequence for giving a bath starts with cleaning the eyes, followed by the face, both arms, chest, hands/nails, abdomen, both legs, perineal hygiene, back, and finally the buttocks/anus. Therefore, the first area to be cleaned during a bath is the eyes. Choices A, C, and D are incorrect as per the standard procedure for providing a bath.

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