Nursing Elites

1. After a hip replacement surgery, a client is instructed to use an abduction pillow while in bed. What is the primary purpose of this device?

• A. To reduce the risk of blood clots.
• B. To prevent hip dislocation.
• C. To improve circulation in the legs.
• D. To alleviate pain and discomfort.

Correct answer: B

Rationale: The primary purpose of using an abduction pillow after hip replacement surgery is to prevent hip dislocation. The abduction pillow keeps the legs separated, which reduces the risk of hip dislocation by preventing excessive internal rotation and adduction of the hip joint. Choices A, C, and D are incorrect as the main goal of using the abduction pillow is to maintain proper positioning and stability of the hip joint to prevent dislocation, rather than addressing blood clots, circulation, or pain relief.

2. The PN is assisting the recreational director of a long-term care facility to plan outdoor activities for wheelchair-bound older residents who are mentally alert. Which activity meets the physical and social needs of these residents?

• A. An open-air concert
• B. A tea party in the courtyard
• C. A team ring-toss competition
• D. A picnic in the park

Correct answer: B

Rationale: A tea party in the courtyard is the most suitable activity as it allows for social interaction in a comfortable and accessible environment. Wheelchair-bound residents can easily participate, fostering both physical and social engagement. An open-air concert may pose challenges regarding accessibility and comfort for wheelchair-bound individuals. A team ring-toss competition involves physical activity that may not be inclusive for all residents, especially those in wheelchairs. A picnic in the park may also present challenges related to accessibility and comfort for wheelchair-bound individuals.

3. A male client with TB returns to the clinic for daily antibiotic injections for a urinary infection. The client has been taking anti-tubercular medications for 10 weeks and states he has ringing in his ears. Which prescribed medication should the PN report to the HCP?

• A. Pyridoxine with a B complex multivitamin
• B. Gentamicin 160 mg IM daily
• C. Rifampin 600 mg PO daily
• D. Isoniazid 300 mg PO daily

Correct answer: B

Rationale: The correct answer is B: Gentamicin 160 mg IM daily. Gentamicin is an aminoglycoside antibiotic that can cause ototoxicity, leading to ringing in the ears (tinnitus). This symptom should be reported to the HCP immediately, as it may indicate a need to adjust or discontinue the medication. Choice A, Pyridoxine with a B complex multivitamin, is not the cause of ototoxicity. Choices C and D, Rifampin and Isoniazid, are anti-tubercular medications but are not associated with causing ringing in the ears.

4. To accommodate a patient who is an Orthodox Jew, you would assure that her diet does not include which of the following?

• A. Any combination of meat and milk at the same meal
• B. Fish with scales
• C. Salmon
• D. Grape juice

Correct answer: A

Rationale: The correct answer is A. Orthodox Jewish dietary laws prohibit mixing meat and dairy in the same meal, so to accommodate an Orthodox Jew, you should ensure that their diet does not include any combination of meat and milk at the same meal. Choices B, C, and D are not prohibited in a kosher diet. Fish with scales, including salmon, are typically kosher, and grape juice is also permissible under kosher guidelines if certified. Therefore, options B, C, and D are acceptable in an Orthodox Jewish diet, while option A contradicts their dietary laws.

5. Which is the most important safety measure when administering a medication through a patient’s central venous catheter (CVC)?

• A. Using a sterile technique
• B. Ensuring correct placement of the CVC
• C. Flushing the CVC with saline after administration
• D. Monitoring for signs of infection

Correct answer: B

Rationale: The most important safety measure when administering a medication through a patient’s central venous catheter (CVC) is ensuring the correct placement of the CVC. This is crucial to prevent complications such as extravasation, infection, or improper drug delivery. While using a sterile technique, flushing the CVC with saline after administration, and monitoring for signs of infection are all important aspects of CVC care, ensuring the correct placement of the catheter takes precedence as it directly impacts patient safety during medication administration.

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