Nursing Elites

1. A healthcare professional is reviewing the medical record of a client who has hypocalcemia. The healthcare professional should identify which of the following findings as a risk factor for the development of this electrolyte imbalance?

• A. Crohn’s disease
• B. Postoperative status following appendectomy
• C. History of bone cancer
• D. Hyperthyroidism

Correct answer: A

Rationale: Crohn’s disease is known to impair calcium absorption, which can lead to hypocalcemia. This condition affects the intestines and can disrupt the normal absorption of nutrients, including calcium. Postoperative status following appendectomy, history of bone cancer, and hyperthyroidism are typically not directly associated with a higher risk of developing hypocalcemia compared to Crohn’s disease.

2. A healthcare provider is preparing to provide chest physiotherapy for a client who has left lower lobe atelectasis. Which of the following actions should the healthcare provider plan to take?

• A. Place the client in Trendelenburg's position.
• B. Position the client in an upright sitting position.
• C. Administer bronchodilators after the procedure.
• D. Perform chest percussion and vibration while the client is lying flat.

Correct answer: A

Rationale: Placing the client in Trendelenburg's position is the appropriate action when providing chest physiotherapy for a client with left lower lobe atelectasis. This position helps mobilize secretions from the lower lobes of the lungs, aiding in their clearance. Trendelenburg's position promotes drainage from the affected area. Positioning the client in an upright sitting position (Choice B) would not facilitate the drainage of secretions from the affected lobe. Administering bronchodilators after the procedure (Choice C) is not directly related to chest physiotherapy and the treatment of atelectasis. Performing chest percussion and vibration while the client is lying flat (Choice D) may not effectively target the lower lobes where the atelectasis is located.

3. A patient is placed in the Sims' position. Which areas will the nurse observe for pressure points?

• A. Chin, elbow, hips
• B. Ileum, clavicle, humerus
• C. Shoulder, anterior iliac spine, ankles
• D. Occipital region of the head, coccyx, heels

Correct answer: B

Rationale: When a patient is placed in the Sims' position, the nurse should observe pressure points on the ileum, clavicle, humerus, knees, and ankles. Choice A is incorrect as the chin and hips are not typically pressure points in the Sims' position. Choice C is incorrect as the shoulder and anterior iliac spine are not commonly observed pressure points in this position. Choice D is also incorrect as the occipital region of the head, coccyx, and heels are not pressure points commonly associated with the Sims' position.

4. A nurse delegates a position change to a nursing assistive personnel. The nurse instructs the assistive personnel (AP) to place the patient in the lateral position. Which finding by the nurse indicates a correct outcome?

• A. Patient is lying on side.
• B. Patient is lying on back.
• C. Patient is lying semiprone.
• D. Patient is lying on abdomen.

Correct answer: A

Rationale: The correct answer is A: 'Patient is lying on side.' In the side-lying (or lateral) position, the patient rests on the side with the major portion of body weight on the dependent hip and shoulder. Choice B, 'Patient is lying on back,' is incorrect as it describes a supine position. Choice C, 'Patient is lying semiprone,' is incorrect as it refers to a position where the patient is partially lying on the abdomen. Choice D, 'Patient is lying on abdomen,' is incorrect as it describes a prone position where the patient is lying face down.

5. A nurse in a mental health unit is preparing to terminate the nurse-client relationship with a client who no longer requires care. Which concept should the nurse and client discuss in the termination phase of the relationship?

• A. Loss
• B. Autonomy
• C. Confidentiality
• D. Accountability

Correct answer: A

Rationale: In the termination phase of a nurse-client relationship, discussing 'loss' is crucial to help the client understand and process the end of the therapeutic relationship and any emotional impact. This discussion can aid in closure and transitioning out of the professional relationship. 'Autonomy' refers to the client's right to make decisions about their care, which is important throughout the relationship but not specifically in the termination phase. 'Confidentiality' is essential for maintaining trust but is not the primary focus during termination. 'Accountability' involves being answerable for one's actions, which is important in nursing practice but not a central topic in the termination phase of the relationship.

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