Nursing Elites

1. When ambulating a client with right-sided weakness, a nursing assistant should be positioned on which side of the client?

• A. Stands behind the client
• B. Positions the free hand on the client's shoulder
• C. Stands on the right side of the client
• D. Grasps the security belt in the midspine area of the small of the client's back

Correct answer: C: Stands on the right side of the client

Rationale: When ambulating a client with right-sided weakness, the nursing assistant should stand on the affected side, which in this case is the client's right side. This position allows the assistant to provide proper support and assistance. Standing behind the client (Choice A) is incorrect as the assistant should be on the affected side. Positioning the free hand on the client's shoulder (Choice B) is a correct action as it helps in pulling the client toward them in case of a forward fall. Grasping the security belt in the midspine area of the small of the client's back (Choice D) is also correct to provide support and stability during ambulation.

2. In a centralized decision-making process within an organization, where is the authority to make decisions vested?

• A. Every employee
• B. A few individuals, such as the board of directors
• C. Many individuals, with decisions filtering down to the individual employee
• D. All nursing employees, pharmacists, and hospital health care providers

Correct answer: A few individuals, such as the board of directors

Rationale: In a centralized decision-making process within an organization, the authority to make decisions is concentrated in a few individuals, such as the board of directors. This means that key decision-making power is held by a select group at the top of the organizational hierarchy. Choices A, C, and D are incorrect because in a centralized structure, decision-making authority is not distributed among every employee, does not filter down to individual employees, and is not shared among all nursing employees, pharmacists, or hospital health care providers. Centralized decision-making implies a more top-down approach.

3. A licensed practical nurse tells the certified nursing assistant (CNA) staff that they will need to comply with the mandatory overtime policy that the long-term care facility has implemented. Later that day, the nurse overhears a CNA complaining about the policy and telling other CNAs that she will not work the overtime if she has made other plans after her regular shift. What is the best approach for the nurse to use in dealing with the conflict?

• A. Providing a positive reward system for the CNA to encourage working the mandatory overtime
• B. Ignoring the complaints
• C. Avoiding assigning the CNA mandatory overtime
• D. Meeting with the CNA regarding her behavior concerning the overtime policy

Correct answer: Meeting with the CNA regarding her behavior concerning the overtime policy

Rationale: In this situation, the best approach for the nurse is to meet with the CNA regarding her behavior concerning the overtime policy. Initiating a discussion is crucial to address resistance by a staff member. A face-to-face meeting allows for the verbalization of feelings, identification of problems, and the opportunity to develop strategies to solve the issue. Ignoring the complaints and avoiding assigning mandatory overtime do not tackle the root of the problem. Providing a positive reward system might offer a temporary fix but does not directly address the resistance and conflict.

4. Which of the following lab values is associated with a decreased risk of cardiovascular disease?

• A. high HDL cholesterol
• B. low HDL cholesterol
• C. low total cholesterol
• D. low triglycerides

Correct answer: high HDL cholesterol

Rationale: The correct answer is high HDL cholesterol. High HDL cholesterol levels are associated with a decreased risk of cardiovascular disease because HDL helps remove LDL cholesterol from the arteries, reducing plaque buildup. Low HDL cholesterol (choice B) is actually associated with an increased risk of cardiovascular disease. Low total cholesterol (choice C) or low triglycerides (choice D) are not indicators of a decreased risk of cardiovascular disease; in fact, extremely low total cholesterol levels may indicate other health issues.

5. Which of the following is not an indication for pelvic ultrasonography?

• A. to measure uterine size
• B. to detect multiple pregnancies
• C. to measure renal size
• D. to detect foreign bodies

Correct answer: C

Rationale: Pelvic ultrasonography is commonly used to assess various conditions. Choices A, B, and D are all valid reasons for performing pelvic ultrasonography. Measuring uterine size helps evaluate conditions like fibroids, while detecting multiple pregnancies is essential for prenatal care. Furthermore, identifying foreign bodies can aid in diagnosing certain conditions. However, assessing renal size is typically not a primary reason for pelvic ultrasonography, making choice C the correct answer.

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