Nursing Elites

1. A healthcare professional is caring for a group of clients. Which of the following measures should the professional take to prevent the spread of infection?

• A. Place a client with TB in a room with negative pressure airflow
• B. Use a disposable gown for contact precautions
• C. Place a client with MRSA in a private room
• D. Use a mask for clients with influenza

Correct answer: A

Rationale: Tuberculosis is an airborne infection, and placing a client with TB in a room with negative pressure airflow helps prevent the spread of the infection by containing the pathogens. This measure is crucial as it prevents the dissemination of TB droplet nuclei to other areas. Choice B, using a disposable gown for contact precautions, is important for preventing the transmission of infections spread by direct or indirect contact. Choice C, placing a client with MRSA in a private room, is essential to prevent the spread of MRSA through contact with others. Choice D, using a mask for clients with influenza, helps prevent the spread of influenza through respiratory droplets. However, negative pressure airflow is specifically required for airborne infections like TB, making it the most appropriate choice in this scenario.

2. A client with rheumatoid arthritis is prescribed prednisone. What information should the LPN/LVN include when teaching the client about this medication?

• A. Take the medication with food to minimize gastrointestinal side effects.
• B. Avoid exposure to sunlight while taking this medication.
• C. Do not discontinue the medication abruptly.
• D. Increase fluid intake while taking this medication.

Correct answer: C

Rationale: The correct answer is C: 'Do not discontinue the medication abruptly.' It is crucial for clients prescribed prednisone to not stop the medication suddenly to prevent adrenal insufficiency, as this medication suppresses the body's natural production of cortisol. Choice A is incorrect because prednisone should be taken with food to minimize gastrointestinal side effects, not necessarily to prevent stomach upset. Choice B is incorrect as there is no specific need to avoid sunlight while taking prednisone. Choice D is not directly related to prednisone use; while adequate fluid intake is generally beneficial, it is not a specific instruction for prednisone administration.

3. A client has a fecal impaction. Before digital removal of the mass, which of the following types of enemas should be administered to soften the feces?

• A. Oil retention
• B. Soapsuds
• C. Saline
• D. Hypertonic

Correct answer: A

Rationale: An oil retention enema is the most appropriate choice to soften and lubricate the feces before digital removal. Oil retention enemas help in making the stool easier to remove digitally due to their lubricating properties. Soapsuds, saline, and hypertonic enemas are not specifically designed to soften feces and are used for different purposes. Soapsuds enemas are used for cleansing, saline enemas for bowel evacuation, and hypertonic enemas for bowel distension in preparation for diagnostic procedures.

4. A client has a prescription for 5 units of regular insulin and 10 units of NPH insulin to mix together and administer subcutaneously. Determine the correct order of steps for this procedure.

• A. Inject 5 units of air into the bottle of regular insulin
• B. Withdraw the correct dose of NPH insulin from the bottle
• C. Inject 10 units of air into the bottle of NPH insulin
• D. Withdraw the correct dose of regular insulin from the bottle

Correct answer: B

Rationale: The correct order of steps for this procedure is to first inject air into the NPH insulin bottle to prevent vacuum formation. After injecting air into the NPH insulin, the next step is to withdraw the correct dose of regular insulin from its bottle. This sequence ensures that the regular insulin is drawn after the NPH insulin, preventing contamination and ensuring accurate dosing. Therefore, choice B is correct. Choices A, C, and D are incorrect because air should be injected into the NPH insulin first, not the regular insulin, and the doses should be withdrawn in the appropriate order to maintain the integrity and potency of each insulin type.

5. A client with a body mass index (BMI) of 30 is seeking advice on the initial approach to a weight loss plan. What action should the nurse recommend?

• A. Plan meals with low carbohydrates and high protein
• B. Engage in strenuous activity for an hour daily
• C. Keep a record of daily food and beverage intake
• D. Participate in a group exercise class three times a week

Correct answer: C

Rationale: Keeping a food diary is an essential practice when starting a weight loss plan as it helps in tracking calorie intake, identifying eating patterns, and making informed decisions about dietary changes. Planning meals with low carbohydrates and high protein (Choice A) can be beneficial for some individuals, but keeping a food diary is more foundational. Engaging in strenuous daily activity (Choice B) may not be sustainable for everyone and could lead to burnout or injuries. Participating in a group exercise class (Choice D) is beneficial for fitness but may not address dietary habits, which are crucial for weight loss.

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