Nursing Elites

1. A client had a total hip arthroplasty. Which of the following prescriptions should the nurse verify with the provider?

• A. Administer enoxaparin 30 mg subcutaneously every 12 hr
• B. Place a wedge or pillow between the client's legs when turning.
• C. Instruct the client to restrict flexion of the hip past 120�.
• D. Encourage the client to perform foot and calf exercises every 2 hr

Correct answer: C

Rationale: Following a total hip arthroplasty, the client should be instructed to restrict hip flexion past 90 degrees to prevent dislocation of the prosthesis. Restricting flexion past 120 degrees is excessive and could lead to complications. Therefore, the nurse should verify this prescription with the provider to ensure the client's safety and proper postoperative care.

2. A client is moving to a new state and needs to find a new doctor and hospital there. What advice by the nurse is best?

• A. Ask the hospitals there about standard nurse-client ratios.
• B. Choose the hospital that has the newest technology.
• C. Find a hospital that is accredited by The Joint Commission.
• D. Use a facility affiliated with a medical or nursing school.

Correct answer: C

Rationale: Choosing a hospital accredited by The Joint Commission (TJC) or another accrediting body is the best advice as it ensures a focus on safety and quality standards.

3. A nursing student learns about modifiable risk factors for coronary artery disease. Which factors does this include? (SATA)

• A. Age
• B. Hypertension
• C. Obesity
• D. Smoking

Correct answer: B

Rationale: Hypertension, obesity, smoking, and excessive stress are all modifiable risk factors for coronary artery disease. Age is a nonmodifiable risk factor as it is a natural process of life.

4. When caring for a client with pneumonia, what intervention is most effective in preventing the spread of infection?

• A. Administer prescribed antibiotics on time.
• B. Encourage the client to use a tissue when coughing.
• C. Place the client in a private room.
• D. Perform hand hygiene before and after client contact.

Correct answer: D

Rationale: The most effective intervention to prevent the spread of infection when caring for a client with pneumonia is performing hand hygiene before and after client contact. This practice helps reduce the transmission of pathogens from one person to another, promoting infection control and maintaining a safe environment for both the client and healthcare provider.

5. A client had an evacuation of a subdural hematoma. Which of the following actions should the nurse take first?

• A. Observe for cerebrospinal fluid (CSF) leaks from the evacuation site.
• B. Assess for an increase in temperature.
• C. Check the oximeter.
• D. Monitor for manifestations of increased intracranial pressure.

Correct answer: C

Rationale: When caring for a client who had an evacuation of a subdural hematoma, the nurse's priority is to check the oximeter. Monitoring oxygen saturation is crucial to ensure adequate tissue oxygenation, especially after such a procedure. This assessment helps in early detection of hypoxemia, which can be detrimental to the client's recovery. While observing for CSF leaks, assessing for temperature changes, and monitoring for signs of increased intracranial pressure are important, checking the oximeter takes precedence to address immediate oxygenation needs.

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