Nursing Elites

1. When caring for a client in the advanced stage of amyotrophic lateral sclerosis (ALS), which of the following referrals is the nurse's priority?

• A. Psychologist
• B. Social worker
• C. Occupational therapist
• D. Speech-language pathologist

Correct answer: D

Rationale: In the advanced stage of ALS, speech and swallowing difficulties become significant. As a result, the priority referral for the nurse would be a speech-language pathologist. This professional can assist in managing communication challenges and provide strategies to address swallowing issues, ensuring the client's safety and quality of life.

2. Which of the following is the correct abbreviation for drops?

• A. Gtt.
• B. Gtts.
• C. Dp.
• D. Dr.

Correct answer: A

Rationale: The correct abbreviation for drops in medical terminology is 'Gtt.' It is derived from the Latin word 'guttae,' meaning drops. The abbreviation 'Gtts.' (Choice B) is incorrect as it adds an unnecessary 's.' Choices C and D, 'Dp.' and 'Dr.,' are not standard abbreviations for drops in medical contexts, making them incorrect.

3. A nurse is talking with another nurse on the unit and smells alcohol on her breath. Which of the following actions should the nurse take?

• A. Confront the nurse about the suspected alcohol use.
• B. Inform another nurse on the unit about the suspected alcohol use.
• C. Ask the nurse to finish administering medications and then go home.
• D. Notify the nursing manager about the suspected alcohol use.

Correct answer: A

Rationale: Confronting the nurse about the suspected alcohol use is the most appropriate action in this situation. It is essential to address the issue directly and express concerns about patient safety and potential impairment. By addressing the situation promptly, the nurse can potentially prevent harm and provide support to the colleague in need.

4. What is the initial technique used when examining a client's abdomen?

• A. Palpation
• B. Auscultation
• C. Percussion
• D. Inspection

Correct answer: D

Rationale: When examining a client's abdomen, the initial technique used is inspection. Inspection involves visually assessing the abdomen for any abnormalities, such as distention, scars, or rashes. This step allows the healthcare provider to gather valuable information before proceeding to other examination techniques like palpation, auscultation, and percussion. Palpation, auscultation, and percussion are secondary techniques used after visual inspection to further assess the abdomen for specific findings. Palpation involves feeling the abdomen for masses or tenderness, auscultation is listening for bowel sounds, and percussion is tapping the abdomen to assess for areas of dullness or resonance.

5. Which of the following patients is at greatest risk for developing pressure ulcers?

• A. An alert chronic arthritic patient treated with steroids and aspirin
• B. An 88-year-old incontinent patient with gastric cancer who is confined to bed at home
• C. An apathetic 63-year-old COPD patient receiving nasal oxygen via cannula
• D. A confused 78-year-old patient with congestive heart failure (CHF) who requires assistance to get out of bed

Correct answer: B

Rationale: The correct answer is B. An elderly patient who is incontinent, bedridden, and suffering from a serious illness like gastric cancer is at the highest risk for developing pressure ulcers. Being bedridden and incontinent increases the pressure on certain areas of the body, leading to tissue damage and the development of pressure ulcers. Additionally, the patient's age and underlying health condition further contribute to their risk. It is crucial to identify and address such risk factors promptly to prevent the occurrence of pressure ulcers in vulnerable patients.

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