Nursing Elites

1. A patient requires repositioning every 2 hours. Which task can the nurse delegate to the nursing assistive personnel?

• A. Determining the level of comfort
• B. Changing the patient's position
• C. Identifying immobility hazards
• D. Assessing circulation

Correct answer: B

Rationale: The correct answer is B: 'Changing the patient's position.' Repositioning the patient involves physically moving and adjusting their position in bed, which is a task that can be safely delegated to nursing assistive personnel (NAP). This task does not require clinical judgment or assessment skills beyond the ability to follow guidelines for proper positioning. Choices A, C, and D involve assessments or judgments that require a higher level of training and knowledge, making them more appropriate for a nurse to perform. Choice A involves assessing comfort, which may involve subjective factors and individual preferences. Choice C involves identifying hazards related to immobility, which requires understanding the potential risks and complications associated with immobility. Choice D involves assessing circulation, which requires a higher level of clinical knowledge and understanding of circulatory issues.

2. During new employee orientation, a nurse is explaining how to prevent IV infections. Which of the following statements by an orientee indicates understanding of the preventive strategies?

• A. “I will leave the IV catheter in place after the client completes the course of IV antibiotics.”
• B. “As long as I am working with the same client, I can use the same IV catheter for my second insertion attempt.”
• C. “If my client needs to use the restroom, it would be safer to disconnect their IV infusion as long as I clean the injection port thoroughly with an antiseptic swab.”
• D. “I will replace any IV catheter when I suspect contamination during insertion.”

Correct answer: D

Rationale: The correct answer is D: “I will replace any IV catheter when I suspect contamination during insertion.” This statement demonstrates an understanding of preventive strategies for IV infections. Suspecting and replacing any contaminated IV catheter during insertion is crucial to prevent infections and ensure patient safety. Choices A, B, and C are incorrect because leaving the IV catheter in place after completing antibiotics, reusing the same IV catheter, and disconnecting the IV infusion without proper precautions can increase the risk of infections. Therefore, option D is the best choice for preventing IV infections.

3. A healthcare professional is collecting data to evaluate a middle adult's psychosocial development. The healthcare professional should expect middle adults to demonstrate which of the following developmental tasks? (Select ONE that does not apply.)

• A. Develop an acceptance of diminished strength and increased dependence on others.
• B. Spend time focusing on improving job performance.
• C. Welcome opportunities to be creative and productive.
• D. Commit to finding friendship and companionship.

Correct answer: A

Rationale: Middle adulthood is a stage where individuals typically focus on various developmental tasks. Option A is incorrect as middle adults do not necessarily develop an acceptance of diminished strength and increased dependence on others; they often strive to maintain independence. Option B is correct as middle adults are usually focused on improving job performance and advancing their careers. Option C is correct as middle adults tend to welcome opportunities to be creative and productive, engaging in new hobbies or projects. Option D is correct as middle adults often commit to finding friendship and companionship as they value social connections and support networks. Therefore, options B, C, and D are the expected developmental tasks for middle adults, making them the correct choices.

4. The nurse is caring for a client who is receiving 24-hour total parenteral nutrition (TPN) via a central line at 54 ml/hr. When initially assessing the client, the nurse notes that the TPN solution has run out and the next TPN solution is not available. What immediate action should the nurse take?

• A. Infuse normal saline at a keep-vein-open rate.
• B. Discontinue the IV and flush the port with heparin.
• C. Infuse 10% dextrose and water at 54 ml/hr.
• D. Obtain a stat blood glucose level and notify the healthcare provider.

Correct answer: C

Rationale: Infusing 10% dextrose and water at 54 ml/hr is the correct action to prevent hypoglycemia until the next TPN solution becomes available. This solution will help maintain the client's glucose levels. Infusing normal saline at a keep-vein-open rate (Choice A) is not appropriate for maintaining glucose levels and would not address the nutritional needs provided by TPN. Discontinuing the IV and flushing the port with heparin (Choice B) is unnecessary and not indicated in this situation as the client still needs fluid and nutrition. Obtaining a stat blood glucose level and notifying the healthcare provider (Choice D) can be done later but is not the immediate action required when the TPN solution has run out.

5. When a nurse instructs a client with hearing loss about cleaning their new hearing aids, which statement indicates that the client understands the instructions?

• A. I use a damp cloth to clean the outside part of my hearing aids.
• B. I clean my hearing aids' ear molds with rubbing alcohol.
• C. I always keep the volume of my hearing aids turned up for better hearing.
• D. I remove the batteries from my hearing aids when not in use at night.

Correct answer: A

Rationale: The correct answer is A because cleaning the outside part of hearing aids with a damp cloth is an appropriate method. Rubbing alcohol can damage ear molds, so choice B is incorrect. Keeping the volume of hearing aids turned up high may lead to discomfort, making choice C incorrect. Removing batteries when not in use at night is good practice for battery life, but it does not directly relate to understanding cleaning instructions, so choice D is less relevant in this context.

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