Nursing Elites

1. A client scheduled for a CT scan of the head with contrast is being taught by a nurse. Which of the following statements by the client indicates a need for further teaching?

• A. I will not eat or drink for 4 hours before the procedure
• B. I will keep my head still throughout the procedure
• C. I will experience a warm sensation when the dye is injected
• D. I can take my morning dose of metformin

Correct answer: D

Rationale: The correct answer is D because metformin should be held before a contrast CT scan to prevent the risk of kidney damage. Choices A, B, and C are all correct statements regarding the preparation and experience of a CT scan with contrast. It is important to fast before the procedure, keep the head still during the scan, and expect a warm sensation when the dye is injected.

2. A nurse manager assigns a task outside the scope of a nursing assistant. How should the assistant respond?

• A. Refuse the task and report it to the charge nurse.
• B. Perform the task without reporting.
• C. Ask another nurse to perform the task.
• D. Accept the task but document it later.

Correct answer: A

Rationale: When a task is assigned that is outside the scope of a nursing assistant, it is essential for the assistant to refuse the task and report it to the charge nurse. This ensures that tasks are appropriately delegated, maintaining patient safety and adherence to professional standards. Performing the task without reporting can lead to potential risks for the patient and legal implications. Asking another nurse to perform the task may not address the issue of improper delegation. Accepting the task but documenting it later does not resolve the immediate concern of working within the assistant's scope of practice and seeking appropriate delegation.

3. A patient recovering from a stroke has difficulty swallowing. Which action should the nurse prioritize?

• A. Begin feeding the patient soft solids.
• B. Place the patient on NPO (nothing by mouth) status.
• C. Provide ice chips to help soothe the throat.
• D. Start the patient on a clear liquid diet.

Correct answer: B

Rationale: The correct answer is to place the patient on NPO (nothing by mouth) status. Patients recovering from a stroke with difficulty swallowing are at high risk for aspiration, which can lead to serious complications like aspiration pneumonia. Therefore, the priority is to keep the patient on NPO until a thorough evaluation by a healthcare provider is completed. Choice A is incorrect as feeding the patient soft solids can increase the risk of aspiration. Choice C is incorrect as providing ice chips may further compromise swallowing safety. Choice D is incorrect as starting the patient on a clear liquid diet can also increase the risk of aspiration in this scenario.

4. When teaching a patient about self-administration of insulin, what is the most important instruction to provide?

• A. Rotate injection sites to prevent tissue damage.
• B. Inject insulin at a 90-degree angle for proper absorption.
• C. Store insulin in the refrigerator to maintain potency.
• D. Teach the patient to administer insulin at the same time each day.

Correct answer: A

Rationale: The most important instruction to provide when teaching a patient about self-administration of insulin is to rotate injection sites to prevent tissue damage. Rotating injection sites helps prevent lipodystrophy (tissue damage) and ensures proper insulin absorption. Option B is incorrect because the angle of insulin injection varies depending on the patient's body composition. Injecting at a 90-degree angle is not always necessary. Option C is not the most crucial instruction; while storing insulin in the refrigerator is important, it is not the priority when teaching self-administration. Option D is also important for maintaining consistency but is not as critical as rotating injection sites to prevent tissue damage.

5. A healthcare provider is assessing a client who has carpal tunnel syndrome. The provider should expect which of the following findings?

• A. Positive Chvostek's sign
• B. Cool extremities
• C. Positive Phalen's sign
• D. Decreased radial pulse

Correct answer: C

Rationale: Phalen's sign is often positive in clients with carpal tunnel syndrome due to nerve compression. Chvostek's sign (Choice A) is related to hypocalcemia, cool extremities (Choice B) are not typically associated with carpal tunnel syndrome, and decreased radial pulse (Choice D) is not a common finding in carpal tunnel syndrome.

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