Nursing Elites

1. When administering parenteral iron, which action would be inconsistent with proper administration?

• A. Using the Z-track method
• B. Using an air bubble to avoid withdrawing medication into subcutaneous tissue
• C. Not massaging the injection site
• D. Using the deltoid muscle for administration

Correct answer: D

Rationale: The correct answer is D: Using the deltoid muscle for administration. Administering parenteral iron in the deltoid muscle is not recommended due to the risk of irritation and pain. The Z-track method (choice A) is preferred to prevent staining and irritation of the skin when administering irritating medications like iron. Using an air bubble (choice B) to avoid withdrawing medication into subcutaneous tissue is a common practice to ensure accurate administration. Not massaging the injection site (choice C) is also a standard practice to prevent potential irritation or bleeding at the injection site.

2. What is a priority when providing care for a patient with a newly inserted tracheostomy?

• A. Keeping the tracheostomy tube clean and dry
• B. Providing regular oral hygiene
• C. Monitoring for signs of infection and ensuring a patent airway
• D. Encouraging the patient to cough and deep breathe

Correct answer: C

Rationale: When caring for a patient with a newly inserted tracheostomy, the priority is to monitor for signs of infection and ensure a patent airway. This is crucial to prevent complications such as airway obstruction or infection. While keeping the tracheostomy tube clean and dry is important for overall care, it is not the highest priority when compared to ensuring a patent airway. Providing regular oral hygiene is essential for the patient's comfort but takes a secondary role to maintaining airway patency. Encouraging the patient to cough and deep breathe may be beneficial but is not as critical as monitoring for infection and keeping the airway clear.

3. When preparing a sterile field for a procedure, which action should the nurse take to maintain sterility?

• A. Place sterile items around the sterile field
• B. Keep hands below waist level to avoid contamination
• C. Open the sterile package away from the body
• D. Avoid reaching over the sterile field

Correct answer: D

Rationale: To maintain sterility when preparing a sterile field, it is essential to avoid reaching over the sterile field. This action can introduce contaminants from the nurse's clothing or unsterile areas, compromising the sterility of the field. Placing sterile items around the sterile field (choice A) is incorrect as it may increase the risk of contamination by extending the area where non-sterile items may come in contact. Keeping hands below waist level (choice B) is also incorrect as it does not prevent contamination effectively. Opening the sterile package away from the body (choice C) is incorrect since it exposes the contents to the nurse's body, which is not sterile.

4. During an inspection of a client's fingernails, the nurse notices a suspected abnormality in the shape and character of the nails. Which finding should the nurse document?

• A. Clubbed nails
• B. Splinter hemorrhages
• C. Longitudinal ridges
• D. Koilonychia or spoon nails

Correct answer: A

Rationale: Clubbed nails are a significant finding in clients with chronic hypoxia or lung disease. This abnormality is characterized by an increased curvature of the nails and softening of the nail bed. It can indicate underlying health conditions such as respiratory or cardiovascular issues. Splinter hemorrhages (B) are small areas of bleeding under the nails, typically associated with infective endocarditis. Longitudinal ridges (C) are often a normal age-related change in the nails. Koilonychia or spoon nails (D) present as a concave shape of the nails and are commonly seen in clients with iron deficiency anemia or hemochromatosis. Therefore, documenting clubbed nails is the most relevant abnormality to report and investigate further.

5. What is the primary function of hemoglobin in red blood cells?

• A. Oxygen transport
• B. Immunity
• C. Blood clotting
• D. Carbon dioxide transport

Correct answer: A

Rationale: The correct answer is A: Oxygen transport. Hemoglobin in red blood cells binds to oxygen in the lungs and carries it to tissues throughout the body, releasing it where needed. This process is essential for cellular respiration and energy production. Choices B, C, and D are incorrect because hemoglobin's primary function is not related to immunity, blood clotting, or carbon dioxide transport. Hemoglobin's main role is to transport oxygen, ensuring adequate oxygen supply to body tissues for metabolic processes.

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