Nursing Elites

1. When preparing to examine a client’s skin using a Wood light, what should the nurse do to facilitate this procedure?

• A. Darken the examining room
• B. Administer a local anesthetic
• C. Obtain a signed informed consent
• D. Shave the skin and scrub it with povidone-iodine (Betadine)

Correct answer: A

Rationale: When using a Wood light to examine the skin, the nurse should darken the examining room. This is necessary because the Wood light emits long-wavelength UV light, which is better visualized in a darkened environment. Administering a local anesthetic (Choice B) is not needed for this procedure. Obtaining a signed informed consent (Choice C) is not directly related to using a Wood light for skin examination. Shaving the skin and scrubbing it with povidone-iodine (Betadine) (Choice D) is not required and may not be appropriate for this type of skin examination.

2. A nursing assistant is measuring the blood pressure (BP) of a hypertensive client while a nurse observes. Which action on the part of the assistant would interfere with accurate measurement and prompt the nurse to intervene? Select all that apply.

• A. Measuring the BP after the client has sat quietly for 5 minutes
• B. Having the client sit with the arm bared and supported at heart level
• C. Using a cuff with a rubber bladder that encircles less than 80% of the limb
• D. Measuring the BP after the client reports that he just drank a cup of coffee

Correct answer: C

Rationale: To ensure accurate blood pressure (BP) measurement, the cuff used should have a rubber bladder that encircles at least 80% of the limb being measured. This ensures proper compression and accurate readings. Choices A and B are correct practices as it is recommended to measure BP after the client has sat quietly for 5 minutes and to have the client sit with the arm bared and supported at heart level. Choice D is also a correct reason for intervention as the client should not have consumed caffeine or smoked tobacco within 30 minutes before BP measurement, as it can affect the accuracy of the reading.

3. The healthcare provider prescribes diagnostic tests for a client with pneumonia identified on a chest X-ray. Which diagnostic test should the nurse review for implementation to guide the most therapeutic treatment of pneumonia?

• A. Sputum culture and sensitivity
• B. Blood cultures
• C. Arterial blood gases (ABG)
• D. Computerized tomography (CT) of the chest

Correct answer: A

Rationale: Sputum culture and sensitivity is the most appropriate diagnostic test for pneumonia as it helps in identifying the causative organism, which is crucial for guiding the selection of the most effective antibiotic therapy. Blood cultures (choice B) are more useful in identifying systemic infections rather than pneumonia specifically. Arterial blood gases (ABG) (choice C) are helpful in assessing oxygenation but do not directly aid in identifying the causative organism. Computerized tomography (CT) of the chest (choice D) is useful for evaluating structural abnormalities in the lungs but is not the initial test of choice for diagnosing pneumonia.

4. When preparing a client who has had a total laryngectomy for discharge, what instruction is most important for the nurse to include in the discharge teaching?

• A. Recommend that the client carry suction equipment at all times.
• B. Instruct the client to have writing materials with them at all times.
• C. Tell the client to carry a medic alert card stating that they are a total neck breather.
• D. Tell the client not to travel alone.

Correct answer: C

Rationale: The most crucial instruction for a client who has had a total laryngectomy is to carry a medic alert card stating that they are a total neck breather. This is important because if they experience a cardiac arrest, mouth-to-neck breathing may be required. Choice A about carrying suction equipment is not the most critical as the client may not always need it. Choice B is not as essential as having a medic alert card. Choice D is not directly related to the client's safety due to their laryngectomy.

5. Prior to a percutaneous kidney biopsy, which actions should a nurse take? (Select all that apply.)

• A. Keep the client NPO for 4 to 6 hours.
• B. Obtain coagulation study results.
• C. Maintain strict bedrest in a supine position.
• D. A & B

Correct answer: D

Rationale: Prior to a percutaneous kidney biopsy, the nurse should ensure that the client is kept NPO for 4 to 6 hours to prevent aspiration during the procedure. Obtaining coagulation study results is crucial to assess the risk of bleeding during and after the biopsy. Strict bedrest in a supine position is not necessary before the procedure. It is important to note that blood pressure medications should be carefully managed, but it is not a pre-procedure action. Keeping the client on bedrest or assessing for blood in the urine are interventions that are more relevant post-procedure to monitor for complications.

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