Nursing Elites

1. How should a healthcare professional care for a patient with a stage 2 pressure ulcer?

• A. Clean the area with normal saline
• B. Apply antibiotic ointment
• C. Use a hydrocolloid dressing
• D. Change the dressing daily

Correct answer: C

Rationale: Using a hydrocolloid dressing is the appropriate care for a stage 2 pressure ulcer because it provides a moist healing environment, promotes healing, and helps to prevent infection. Cleaning the area with normal saline (Choice A) is important but not the primary treatment for a stage 2 pressure ulcer. Applying antibiotic ointment (Choice B) may not be necessary unless there is a sign of infection. Changing the dressing daily (Choice D) may disrupt the healing process and is not recommended unless the dressing is soiled or compromised.

2. A nurse is caring for a client who has pneumonia. Which of the following manifestations should the nurse expect?

• A. Bradycardia
• B. Hypertension
• C. Tachypnea
• D. Hypothermia

Correct answer: C

Rationale: The correct answer is C: Tachypnea. When caring for a client with pneumonia, the nurse should expect tachypnea, which is rapid breathing. This occurs due to decreased oxygenation and lung function. Bradycardia (A) is not typically associated with pneumonia; instead, tachycardia may be present. Hypertension (B) is not a common manifestation of pneumonia; instead, hypotension may occur due to sepsis. Hypothermia (D) is not a typical finding in pneumonia; fever or an elevated temperature is more common.

3. A nurse is assessing a newborn who is 1-day old and receiving phototherapy for jaundice. Which action should the nurse take?

• A. Feed the infant glucose water every 2 hours.
• B. Ensure the newborn wears a diaper.
• C. Keep the infant's head covered with a cap.
• D. Apply lotion to the newborn every 4 hours.

Correct answer: C

Rationale: The correct action for the nurse to take is to keep the infant's head covered with a cap. This helps regulate the newborn's body temperature during phototherapy. Option A, feeding the infant glucose water every 2 hours, is incorrect because it is not a standard intervention for newborns receiving phototherapy. Option B, ensuring the newborn wears a diaper, may be necessary for hygiene but is not directly related to phototherapy. Option D, applying lotion to the newborn every 4 hours, is unnecessary and not indicated for managing jaundice or phototherapy.

4. How should signs of infection in a post-surgical patient be assessed?

• A. Check the surgical site
• B. Check the patient's vital signs
• C. Monitor for fever
• D. Check for abnormal breath sounds

Correct answer: A

Rationale: Assessing the surgical site is crucial in identifying early signs of infection post-surgery. Changes such as redness, swelling, warmth, or drainage may indicate an infection developing. While monitoring vital signs and fever are important in infection assessment, they are general indicators and may not show localized signs at the surgical site. Checking for abnormal breath sounds is more relevant when assessing respiratory issues rather than infection at the surgical site.

5. A nurse is providing discharge teaching to a client who has a new prescription for digoxin. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will take my pulse before taking this medication.
• B. I should take this medication with food to prevent nausea.
• C. I will take this medication if my heart rate is less than 60/min.
• D. I should take this medication with food if I am not feeling well.

Correct answer: A

Rationale: The correct answer is A. Taking the pulse before taking digoxin is crucial as it helps monitor the heart rate, as digoxin can cause bradycardia as a side effect. Option B is incorrect because digoxin should be taken on an empty stomach to enhance absorption. Option C is incorrect because digoxin should be held and the healthcare provider should be contacted if the heart rate is less than 60/min. Option D is incorrect because digoxin should not be taken with food due to decreased absorption.

Similar Questions