Nursing Elites

1. A nurse is working in a pediatric clinic, and a 25-year-old mother comes in with a 4-week-old baby. The mother is stressed out about the loss of sleep, and the baby exhibits signs of colic. Which of the following techniques should the nurse teach the mother?

• A. Distraction of the infant with a red object
• B. Prone positioning techniques
• C. Tapping reflex techniques
• D. Neural warmth techniques

Correct answer: D

Rationale: Neural warmth techniques involve the caregiver providing a warm, soothing touch to the baby, which can help to lower the baby's agitation level and promote relaxation. This technique is beneficial for calming colicky babies. Choices A, B, and C are incorrect because distraction with a red object, prone positioning, and tapping reflex techniques are not effective methods for managing colic in infants. Red object distraction is not a proven technique for soothing colicky babies. Prone positioning is not recommended for infants due to the risk of sudden infant death syndrome (SIDS). Tapping reflex techniques are not recognized as effective interventions for colic.

2. Which of the following viruses is most likely to be acquired through casual contact with an infected individual?

• A. influenza virus
• B. herpes virus
• C. cytomegalovirus (CMV)
• D. human immunodeficiency virus (HIV)

Correct answer: A

Rationale: The correct answer is influenza virus. Influenza virus is most likely to be acquired through casual contact with an infected individual as it is transmitted through respiratory droplets. Herpes virus is primarily transmitted by direct contact, such as skin-to-skin contact, making it less likely to be acquired through casual contact. HIV is mainly transmitted through blood and body fluids like semen and vaginal fluids, not through casual contact. Cytomegalovirus (CMV) is an opportunistic infection commonly affecting immunocompromised individuals and is usually transmitted through close personal contact, not casual contact.

3. When teaching a patient with COPD pulmonary exercises, what should be done?

• A. Teach pursed-lip breathing techniques.
• B. Encourage repetitive heavy lifting exercises to increase strength.
• C. Limit exercises due to respiratory acidosis.
• D. Take breaks every 10-20 minutes during exercises.

Correct answer: A

Rationale: The correct answer is to teach pursed-lip breathing techniques. Pursed-lip breathing helps to decrease the volume of air expelled by keeping the airways open longer, making it easier for patients with COPD to breathe out. Encouraging heavy lifting exercises (Choice B) is not suitable for patients with COPD as it can lead to increased shortness of breath. Limiting exercises due to respiratory acidosis (Choice C) is not correct; instead, exercises should be tailored to the patient's tolerance. Taking breaks every 10-20 minutes (Choice D) is not specific to the management of COPD pulmonary exercises.

4. A nurse assesses an 83-year-old female's venous ulcer for the second time that is located near the right medial malleolus. The wound is exhibiting purulent drainage, and the patient has limited mobility in her home. Which of the following is the best course of action?

• A. Encourage warm water soaks to the right foot.
• B. Notify the case manager of the purulent drainage.
• C. Determine the patient's pulse in the right ankle.
• D. Recommend increased activity to reduce the purulent drainage.

Correct answer: A

Rationale: The correct course of action is to encourage warm water soaks to the right foot. This can help promote wound healing and alleviate discomfort. Before recommending increased activity or notifying additional team members, it is crucial to assess arterial blood flow by determining the patient's pulse in the right ankle. Poor arterial blood flow could worsen the condition, making increased activity inappropriate. While notifying the case manager of purulent drainage is important, addressing the wound care directly should be the primary focus at this stage.

5. The LPN is preparing to ambulate a client post total knee replacement. Which of the following actions should the nurse perform prior to ambulating the client?

• A. Assist the client to a sitting position at the edge of the bed
• B. Have the client march in place for 30 seconds
• C. Have the client raise his arms above his head
• D. Ask the client the last time he fell

Correct answer: A

Rationale: The correct action to perform before ambulating a client post total knee replacement is to assist the client to a sitting position at the edge of the bed. This step is crucial to prevent orthostatic hypotension and ensure the client is ready to stand and walk safely. Having the client march in place or raise his arms above his head are not necessary preparations for ambulation. While knowing about the client's fall history is important for safety reasons, it is not the priority action immediately before ambulating the client.

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