Nursing Elites

1. Before donning gloves to perform a procedure, proper hand hygiene is essential. The healthcare professional understands that the most important aspect of hand hygiene is the amount of:

• A. Temperature
• B. Time
• C. Friction
• D. Soap

Correct answer: C

Rationale: The correct answer is C: Friction. The amount of friction is crucial in effective hand hygiene to remove microorganisms. Rubbing hands together with friction helps to dislodge and remove dirt, oils, and microorganisms. While temperature and soap are important factors in hand hygiene, the mechanical action of friction plays a more significant role in physically removing contaminants. Time is also important in hand hygiene practice, but without adequate friction, the effectiveness of the process is compromised.

2. A nurse is teaching the parents of a toddler about discipline. Which of the following actions should the nurse suggest?

• A. Establish consistent boundaries for the toddler.
• B. Place the toddler in a room with the door closed.
• C. Inform the toddler how you feel when he misbehaves.
• D. Use a favorite snack to reward the toddler.

Correct answer: A

Rationale: The correct answer is to establish consistent boundaries for the toddler. This approach helps toddlers understand expectations and promotes consistent behavior. Placing the toddler alone or using food rewards may not effectively teach discipline and could be inappropriate. Informing the toddler about feelings when misbehaving may not be developmentally appropriate for a toddler to understand the consequences of their actions.

3. During auscultation of the anterior chest wall of a client newly admitted to a medical-surgical unit, what type of breath sounds should a nurse expect to hear?

• A. Normal breath sounds
• B. Adventitious breath sounds
• C. Absent breath sounds
• D. Diminished breath sounds

Correct answer: A

Rationale: During auscultation of the chest, normal breath sounds are the expected findings in a client who is newly admitted without respiratory complaints. Normal breath sounds indicate proper airflow through the airways without any abnormalities. Adventitious breath sounds (Choice B) refer to abnormal lung sounds such as crackles or wheezes, which are indicative of underlying respiratory issues. Absent breath sounds (Choice C) suggest a lack of airflow to a particular lung area, which could be due to conditions like pneumothorax. Diminished breath sounds (Choice D) indicate reduced airflow or consolidation in a specific lung region, often seen in conditions like pleural effusion or pneumonia. Therefore, in a newly admitted client without respiratory complaints, the nurse should expect to hear normal breath sounds during auscultation.

4. When lifting a bedside cabinet to move it closer to a client who is sitting in a chair, which of the following actions should the nurse take to prevent self-injury?

• A. Bend at the waist
• B. Keep feet close together
• C. Use back muscles for lifting
• D. Stand close to the cabinet when lifting it

Correct answer: D

Rationale: The correct answer is to stand close to the cabinet when lifting it. This action keeps the object close to the nurse's center of gravity, reducing the risk of back strain. Bending at the waist (Choice A) can increase the risk of back injury as it puts strain on the lower back. Keeping feet close together (Choice B) does not provide a stable base of support for lifting a heavy object. Using back muscles for lifting (Choice C) is incorrect as it can lead to back strain and injury. Therefore, standing close to the cabinet when lifting it is the safest and most effective approach to prevent self-injury.

5. The nurse is caring for an older adult patient diagnosed with Alzheimer's disease who is ambulatory but requires total assistance with activities of daily living (ADLs). The nurse notices that the patient is edentulous. Which area should the nurse assess?

• A. Assess oral cavity.
• B. Assess room for drafts.
• C. Assess ankles for edema.
• D. Assess for reduced sensations.

Correct answer: A

Rationale: The correct answer is to assess the oral cavity. 'Edentulous' means without teeth, so the nurse should assess the oral cavity for any issues related to oral health, dentures, or potential complications. This assessment is crucial to prevent oral health problems and ensure proper care for the patient. Assessing the room for drafts (choice B) is unrelated to the patient's edentulous status and does not address the immediate care needs. Assessing ankles for edema (choice C) is important for circulatory assessment but not directly related to the patient being edentulous. Assessing for reduced sensations (choice D) would be more relevant for neurological or sensory concerns, which are not specifically associated with being edentulous.

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