Nursing Elites

1. Mr. and Mrs. K have just adopted a newborn infant and are preparing to take him home from the hospital for the first time. Which safety measure is most appropriate for the clients in this situation?

• A. Turn the handles of pans on the stove inward
• B. Set up a baby gate at the top of the stairs
• C. Cover electrical outlets with child-proof plugs
• D. Install an approved car seat that is facing backward in the back seat

Correct answer: D

Rationale: Parents of newborn infants should use an approved car seat that has been installed facing backward in the back seat of the car. Securing infants in car seats, even from the first ride home from the hospital, promotes safety while transporting. While safety measures at home such as baby gates or outlet covers are important, they are not the priority safety measures until the baby is old enough to be mobile. The car seat is crucial for protecting the newborn during transportation, ensuring proper positioning and restraint in the event of sudden stops or accidents. Turning handles of pans on the stove inward, setting up a baby gate, and covering electrical outlets are important safety measures at home but are not as critical for the immediate safety of a newborn during transportation.

2. Improper placement of the hands under the rib cage when performing the Heimlich maneuver could result in:

• A. damage to the manubrium of the sternum.
• B. damage to the xiphoid process.
• C. damage to the coccyx.
• D. None of the above is possible, even with improper hand placement.

Correct answer: B

Rationale: The xiphoid process is a small, cartilaginous extension at the inferior end of the sternum. Placing the hands improperly during the Heimlich maneuver too close to this process can result in it breaking off and potentially causing damage to internal organs. Choices A and C are incorrect because the manubrium of the sternum and the coccyx are not in the area where the hands would typically be placed during the Heimlich maneuver.

3. In which of the following ways can a nurse promote sleep for a client experiencing insomnia?

• A. Assist the client in using the bathroom one hour after going to bed
• B. Give the client a massage before bedtime
• C. Tuck bed sheets and blankets tightly around the client once settled in bed
• D. Give the client a pair of socks to wear if their feet become cold

Correct answer: D

Rationale: A nurse can promote sleep for a client experiencing insomnia by addressing factors that may hinder sleep. Cold feet can disrupt sleep, so providing the client with socks to keep their feet warm can enhance comfort and aid in promoting sleep. The correct answer focuses on a direct intervention to address a specific issue that can impact sleep quality. Choices A, B, and C do not directly address the issue of cold feet, which is a common problem that can interfere with sleep in individuals with insomnia. Assisting the client to use the bathroom, giving a massage in the morning, or tucking in bed sheets tightly do not target the discomfort caused by cold feet, making them less effective interventions for promoting sleep in this scenario.

4. After receiving change-of-shift report, which patient should the nurse assess first?

• A. A patient with pneumonia who has crackles in the right lung base
• B. A patient with possible lung cancer who has just returned after bronchoscopy
• C. A patient with hemoptysis and a 16-mm induration with tuberculin skin testing
• D. A patient with chronic obstructive pulmonary disease (COPD) and pulmonary function testing (PFT) that indicates low forced vital capacity

Correct answer: B

Rationale: The correct answer is the patient with possible lung cancer who has just returned after bronchoscopy. After bronchoscopy, the patient may have decreased cough and gag reflexes, necessitating immediate assessment for airway patency to prevent potential complications. The other patients do not exhibit urgent clinical manifestations or have undergone recent procedures that require immediate attention. Therefore, they can be assessed after ensuring the safety and stability of the patient who has just returned after bronchoscopy.

5. The NFPA diamond has four colors. The blue diamond:

• A. indicates hazards to health.
• B. designates that it is safe to use water to put out this type of fire.
• C. indicates that ice is necessary to treat an injury with this type of chemical.
• D. indicates that the chemical may be incinerated upon disposal.

Correct answer: A

Rationale: The National Fire Protection Agency (NFPA) uses a safety diamond to communicate the level of threat posed by a specific chemical. The blue diamond in the NFPA diamond system signifies potential health hazards associated with the use of that chemical. Choice B is incorrect because the blue diamond does not indicate anything about using water to extinguish fires. Choice C is incorrect as the NFPA diamond does not provide information on treating injuries. Choice D is also incorrect as the blue diamond does not suggest incineration upon disposal; it pertains to health hazards.

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