Nursing Elites

1. A nurse is caring for a group of patients. Which of the following clients should the nurse refer to a social worker?

• A. A patient who requests to secure an emergency notification system in the home.
• B. A client who requires placement in an assisted living facility.
• C. A patient who requests to get school assignments while hospitalized on a pediatric unit.
• D. A patient who is experiencing food insecurity.

Correct answer: B

Rationale: The correct answer is B because social workers are involved in arranging care services like placement in assisted living facilities. This client's need for placement in an assisted living facility requires the expertise and assistance of a social worker. Choices A, C, and D do not necessarily require the intervention of a social worker. Choice A can be addressed by a nurse or healthcare provider, choice C can be managed by hospital staff or educators, and choice D may involve a nutritionist or community outreach programs.

2. A nurse is preparing to administer TPN with added fat supplements to a client who has malnutrition. Which of the following actions should the nurse take?

• A. Administer the TPN solution separately from 0.9% sodium chloride
• B. Check for an allergy to eggs
• C. Discuss the TPN solution with the client
• D. Monitor for hypoglycemia

Correct answer: B

Rationale: The correct action for the nurse to take when preparing to administer TPN with fat supplements is to check for an allergy to eggs. The lipid emulsion in TPN often contains egg phospholipids, so screening for egg allergies is crucial to prevent any adverse reactions. Option A is incorrect because TPN should not be piggybacked with 0.9% sodium chloride to avoid any interactions or dilution of the TPN solution. Option C is incorrect as discussing the TPN solution with the client is not the priority when preparing to administer it. Option D is incorrect as monitoring for hypoglycemia, although important in TPN administration, is not specifically related to the addition of fat supplements.

3. A nurse is reviewing psychosocial stages of development for a school-age child. What would be an expected behavioral finding for this child?

• A. Personalize values and beliefs and base reasoning on ethical fairness principles.
• B. Develop a sense of personal identity that is influenced by family expectations.
• C. Develop a sense of industry through advances in learning.
• D. Take on new experiences and when unable to accomplish tasks, may feel guilty.

Correct answer: C

Rationale: The correct answer is C. School-age children (6-12 years) are in Erikson's stage of industry vs. inferiority. During this stage, they strive to develop a sense of industry through learning and socialization. They seek to excel in various areas, such as schoolwork or activities, and look for approval from peers and adults. Choices A, B, and D are incorrect because personalizing values and beliefs, developing personal identity influenced by family expectations, and feeling guilty for inability to accomplish tasks are not typical behavioral findings for a school-age child in the context of psychosocial development.

4. A nurse is using Naegele’s rule to calculate the expected delivery date for a client whose last menstrual period was in October. What is the expected date?

• A. 711
• B. 1011
• C. 411
• D. 1211

Correct answer: A

Rationale: Using Naegele’s rule, to calculate the expected delivery date, you add one year, subtract three months, and add seven days to the first day of the last menstrual period. If the last menstrual period was in October, adding one year gives October of the following year. Subtracting three months gives July, and adding seven days gives the expected delivery date of July 11th. Therefore, the correct answer is 711. Choice B (1011) is incorrect as it doesn't follow Naegele’s rule calculations. Choices C (411) and D (1211) are also incorrect as they do not align with the correct application of Naegele’s rule.

5. A healthcare provider is assessing a client who has a long arm cast. Which of the following findings indicates a moderate complication when assessing for acute compartment syndrome?

• A. Shortness of breath
• B. Petechiae
• C. Change in mental status
• D. Edema

Correct answer: D

Rationale: Edema is a common sign of acute compartment syndrome, which is a medical emergency caused by increased pressure within a muscle compartment, requiring immediate intervention. Shortness of breath (Choice A) is more indicative of a respiratory issue rather than acute compartment syndrome. Petechiae (Choice B) are pinpoint, round spots that appear on the skin due to bleeding under the skin and are not typically associated with acute compartment syndrome. Change in mental status (Choice C) is more suggestive of neurological issues rather than acute compartment syndrome.

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