Nursing Elites

1. A caregiver is talking with the caregivers of a 10-year-old child who is concerned that their child is becoming secretive, including closing the door when showering and dressing. Which of the following responses should the caregiver make?

• A. “Perhaps you should try to find out what is happening behind those closed doors.”
• B. “Suggest that the door be left ajar for safety reasons.”
• C. “At this age, children tend to become modest and value their privacy.”
• D. “You should establish a disciplinary plan to stop this behavior.”

Correct answer: C

Rationale: The correct response is C: “At this age, children tend to become modest and value their privacy.” During the developmental stage around 10 years old, children often start to value their privacy more and exhibit behaviors like closing doors when showering or dressing. It is a normal part of growing up and developing a sense of modesty. Choice A is incorrect as it suggests prying into the child's privacy, which may be counterproductive and invasive. Choice B is not the best response as it focuses on safety but fails to address the child's developmental stage and need for privacy. Choice D is also incorrect as it advocates for discipline without recognizing the normal developmental behavior of children at this age.

2. During assessment, what is a nurse monitoring when assessing body alignment?

• A. The relationship of one body part to another in different positions
• B. The coordination between musculoskeletal and nervous systems
• C. The force opposing movement direction
• D. The ability to move freely

Correct answer: A

Rationale: When a nurse assesses body alignment, they are observing the relationship of one body part to another in various positions. This involves evaluating the positioning of joints, tendons, ligaments, and muscles while a person is standing, sitting, or lying down. Choice B is incorrect because it refers more to the coordination between the musculoskeletal and nervous systems, which is not specifically related to body alignment assessment. Choice C is incorrect as it describes the force opposing movement rather than body alignment. Choice D is incorrect as it defines the ability to move freely, which is not directly related to monitoring body alignment.

3. After completing an assessment and determining that a client has a problem, what should the LPN/LVN do next?

• A. Determine the etiology of the problem.
• B. Prioritize nursing care interventions.
• C. Plan appropriate interventions.
• D. Collaborate with the client to set goals.

Correct answer: A

Rationale: After identifying a problem in a client, the next step for the LPN/LVN is to determine the etiology or cause of the problem. Understanding the root cause of the issue is essential as it guides the development of appropriate interventions. Option B, prioritizing nursing care interventions, is premature without knowing the cause of the problem. Option C, planning appropriate interventions, also relies on knowing the etiology first to ensure the interventions directly address the underlying issue. Collaborating with the client to set goals, as mentioned in option D, is important but typically comes after understanding the cause of the problem to ensure the goals are relevant and effective.

4. The LPN observes an unlicensed assistive personnel (UAP) taking a client's blood pressure with a cuff that is too small, but the blood pressure reading obtained is within the client's usual range. What action is most important for the nurse to implement?

• A. Tell the UAP to use a larger cuff at the next scheduled assessment.
• B. Reassess the client's blood pressure using a larger cuff.
• C. Have the unit educator review this procedure with the UAPs.
• D. Teach the UAP the correct technique for assessing blood pressure.

Correct answer: B

Rationale: Reassessing the client's blood pressure using a larger cuff is the most important action for the nurse to implement in this situation. Using the correct cuff size is crucial for obtaining accurate blood pressure readings. By reassessing with a larger cuff, the nurse can ensure an accurate measurement and proper monitoring of the client's blood pressure. Choice A is not the best option as it doesn't address the immediate need for accurate blood pressure measurement. Choice C is not the most appropriate action at this time since the immediate concern is ensuring correct blood pressure assessment. Choice D, while important, is not the most critical step in this scenario where immediate reassessment is needed with the correct cuff size.

5. A healthcare professional is teaching about home safety with a client. Which of the following instructions should the healthcare professional include?

• A. Unplug electronics by holding the plug
• B. Use electrical tape to secure extension cords next to baseboards on the floor
• C. To use a fire extinguisher, aim at the base of the flames
• D. Install slip-resistant rugs on tile floors

Correct answer: B

Rationale: The correct answer is to use electrical tape to secure extension cords next to baseboards on the floor. This practice helps prevent tripping and electrical hazards by keeping cords out of the way. Option A is incorrect as unplugging electronics should be done by holding the plug, not the cord itself. Option C is incorrect because when using a fire extinguisher, it should be aimed at the base of the flames, not at the top. Option D is not directly related to home safety teaching and may not be necessary for all clients, as it suggests an unnecessary change that may not improve safety.

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