Nursing Elites

1. How should a healthcare professional manage a patient with a tracheostomy?

• A. Monitor airway patency and provide humidified oxygen
• B. Provide education on tracheostomy care
• C. Suction airway secretions and change tracheostomy ties
• D. Provide a high-protein diet and ensure fluid restriction

Correct answer: A

Rationale: Correct answer: Monitoring airway patency and providing humidified oxygen is crucial in managing a patient with a tracheostomy to ensure proper breathing and oxygenation. Ensuring the airway is clear and providing oxygen support are immediate priorities. Providing education on tracheostomy care (Choice B) is important for long-term management but not the immediate priority. Suctioning airway secretions and changing tracheostomy ties (Choice C) are tasks that may be necessary but do not address the primary concern of maintaining airway patency. Providing a high-protein diet and ensuring fluid restriction (Choice D) are unrelated to the immediate management of a tracheostomy.

2. A client with type 2 diabetes mellitus is being taught about insulin administration by a nurse. Which of the following instructions should the nurse include?

• A. Inject insulin into the muscle
• B. Rotate injection sites with each dose
• C. Store insulin at room temperature
• D. Massage the injection site after administration

Correct answer: B

Rationale: The correct instruction that the nurse should include is to rotate injection sites with each dose. This practice is essential to prevent tissue damage and ensure proper insulin absorption. Option A is incorrect because insulin should not be injected into the muscle, but rather into the subcutaneous tissue. Option C is incorrect as insulin should be stored in the refrigerator to maintain its effectiveness. Option D is incorrect as massaging the injection site after administration can lead to faster absorption and potentially hypoglycemia.

3. How can a healthcare provider prevent deep vein thrombosis (DVT) in post-operative patients?

• A. Encourage early ambulation
• B. Administer anticoagulants
• C. Apply compression stockings
• D. All of the above

Correct answer: D

Rationale: All of the above options are essential in preventing deep vein thrombosis (DVT) in post-operative patients. Encouraging early ambulation helps prevent blood stasis in the lower extremities, reducing the risk of DVT. Administering anticoagulants can prevent blood clots from forming. Compression stockings promote blood flow, reducing the likelihood of clot formation. Each intervention plays a crucial role in DVT prevention, making the correct answer 'All of the above.' Choices A, B, and C are not exclusive of each other but rather work synergistically to provide comprehensive prevention against DVT.

4. The nurse is performing triage on a group of clients in the emergency department. Which of the following clients should the nurse see first?

• A. A 12-year-old oozing blood from a laceration on the left thumb due to a cut from a rusty metal can
• B. A 19-year-old with a fever of 103.8°F who is able to identify her sister but not the place and time
• C. A 49-year-old with a compound fracture of the right leg who is complaining of severe pain
• D. A 65-year-old with a flushed face, dry mucous membranes, and a blood sugar of 470 mg/dL

Correct answer: B

Rationale: The correct answer is B. A 19-year-old with a fever of 103.8°F who is confused and unable to orient to place and time likely has a severe infection or a serious medical condition affecting the central nervous system. This client needs immediate attention as altered mental status combined with a high fever can indicate a life-threatening situation. Choices A, C, and D present important conditions that require medical care, but they are not as urgent as the 19-year-old with a high fever and confusion. The 12-year-old with a laceration may require treatment for bleeding and a tetanus shot, the 49-year-old with a compound fracture needs urgent orthopedic intervention, and the 65-year-old with a high blood sugar is concerning for hyperglycemia but can wait momentarily compared to the client with a fever and altered mental status.

5. What should a healthcare provider prioritize for a client diagnosed with bipolar disorder?

• A. Monitor for hyperactivity
• B. Monitor for signs of depression
• C. Monitor for changes in self-esteem
• D. Monitor for changes in energy levels

Correct answer: B

Rationale: When caring for a client diagnosed with bipolar disorder, the priority is to monitor for signs of depression. Individuals with bipolar disorder are at risk of severe depressive episodes, making it crucial to watch for signs of depression. While changes in energy levels and self-esteem are common in bipolar disorder, they are not the primary focus. Hyperactivity is a characteristic of the manic phase of bipolar disorder, so monitoring for depression is the priority in this case.

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