Nursing Elites

1. When planning to insert a peripheral IV catheter for an older adult client, which of the following actions should the nurse plan to take?

• A. Insert the catheter at a 45° angle
• B. Place the client's arm in a dependent position
• C. Shave excess hair from the insertion site
• D. Initiate IV therapy in the veins of the hand

Correct answer: B

Rationale: Placing the client's arm in a dependent position is the correct action when inserting a peripheral IV catheter for an older adult client. This position helps veins dilate due to gravity, facilitating easier insertion of the IV catheter. Choice A is incorrect because catheters are typically inserted at a lower angle, around 10-30 degrees. Choice C is unnecessary unless excessive hair impedes the insertion process. Choice D is incorrect as veins in the hand are generally smaller and more prone to complications, making them less ideal for IV therapy in older adults.

2. A client has C-diff infection. Which of the following actions should the nurse take?

• A. Give the client chlorhexidine gluconate for hand hygiene.
• B. Remove the protective gown first when exiting the client's room.
• C. Use alcohol-based hand rub when caring for the client.
• D. Initiate contact precautions when providing client care.

Correct answer: D

Rationale: The correct answer is to initiate contact precautions when providing client care. C-diff (Clostridium difficile) is highly contagious, and contact precautions are necessary to prevent its spread. Giving the client chlorhexidine gluconate for hand hygiene (Choice A) is not specific to managing C-diff. Removing the protective gown first when exiting the client's room (Choice B) may increase the risk of contaminating oneself and the environment. Using alcohol-based hand rub when caring for the client (Choice C) is not sufficient to prevent the transmission of C-diff, as soap and water are more effective against this particular pathogen.

3. During a health assessment, a client who takes herbal supplements makes a statement indicating an understanding of their use. Which statement is most indicative of this understanding?

• A. I use garlic for my menopausal symptoms.
• B. I use ginger when I get car sick.
• C. I take ginkgo biloba for headaches.
• D. I take echinacea to control cholesterol.

Correct answer: C

Rationale: The correct answer is C because ginkgo biloba is commonly used to help with headaches, among other benefits. Choices A, B, and D are incorrect because garlic is not typically used for menopausal symptoms, ginger is mainly used for nausea and vomiting (not car sickness specifically), and echinacea is not known to control cholesterol.

4. A healthcare professional is reviewing a plan of care for a client who was admitted with dehydration as a result of prolonged watery diarrhea. Which prescription should the healthcare professional question?

• A. Oral psyllium (Metamucil)
• B. Oral potassium supplement
• C. Parenteral half normal saline
• D. Parenteral albumin (Albuminar)

Correct answer: D

Rationale: The correct answer is D, Parenteral albumin (Albuminar). Parenteral albumin is not typically indicated for dehydration resulting from diarrhea. In this case, fluid replacement therapy with intravenous fluids such as parenteral half normal saline would be more appropriate. Oral psyllium and oral potassium supplement are not the primary interventions for managing dehydration due to watery diarrhea. Oral psyllium is a fiber supplement used for constipation rather than diarrhea. Oral potassium supplements may be necessary if potassium levels are low due to dehydration, but the priority is fluid replacement. Therefore, choices A and B are less relevant in this scenario.

5. The patient is reporting an inability to clear nasal passages. Which action will the nurse take?

• A. Use gentle suction to prevent tissue damage.
• B. Instruct the patient to blow their nose forcefully to clear the passage.
• C. Place a dry washcloth under the nose to absorb secretions.
• D. Insert a cotton-tipped applicator into the back of the nose.

Correct answer: A

Rationale: When a patient reports an inability to clear nasal passages, the appropriate action for the nurse to take is to use gentle suction to prevent tissue damage. Suctioning helps remove excess mucus or secretions without causing harm to the nasal tissues. Instructing the patient to blow their nose forcefully (Choice B) may exacerbate the issue and cause discomfort or injury. Placing a dry washcloth under the nose (Choice C) is not an effective intervention for clearing nasal passages. Inserting a cotton-tipped applicator into the back of the nose (Choice D) is not recommended as it can be invasive and may cause injury or discomfort to the patient.

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