Nursing Elites

1. The nurse is caring for the client one (1) day postoperative sigmoid colostomy operation. Which independent nursing intervention should the nurse implement?

• A. Change the infusion rate of the intravenous fluid
• B. Encourage the client to discuss his or her feelings
• C. Administer opioid narcotic medications for pain management
• D. Assist the client out of bed to sit in the chair twice daily

Correct answer: D

Rationale: Assisting the client to sit in a chair is a crucial nursing intervention postoperatively. It helps prevent complications such as thrombosis, pneumonia, and pressure ulcers by promoting circulation and aiding in recovery. Changing the infusion rate of the intravenous fluid would require a physician's order and is not within the nurse's independent scope of practice. Encouraging the client to discuss feelings and administering medications for pain management are important interventions but may not be as immediately necessary as assisting the client in mobilizing early postoperatively.

2. When does the nurse act as a client advocate?

• A. Pulling the curtain around the client's bed while changing a dressing
• B. Contacting the health care provider to request a meeting for the client
• C. Ensuring access to medical information by appropriate personnel only
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Acting as a client advocate involves various actions to protect the client's rights and well-being. Pulling the curtain around the client's bed while changing a dressing ensures privacy and dignity. Contacting the health care provider to request a meeting for the client facilitates communication and addresses the client's needs. Ensuring access to medical information by appropriate personnel only safeguards the client's confidentiality and privacy. Therefore, all the actions mentioned in choices A, B, and C are examples of a nurse acting as a client advocate, making D the correct answer.

3. When assessing the integumentary system of a client with anorexia nervosa, which finding would support the diagnosis?

• A. Preoccupation with calories
• B. Thick body hair
• C. Sore tongue
• D. Dry, brittle hair

Correct answer: D

Rationale: Dry, brittle hair is a common sign of malnutrition, often seen in clients with anorexia nervosa. In anorexia nervosa, the body lacks essential nutrients due to severe calorie restriction, leading to dryness and brittleness of the hair. Choices A, B, and C are less likely to directly indicate anorexia nervosa. Preoccupation with calories can be a behavioral symptom, thick body hair is not a typical finding associated with anorexia nervosa, and a sore tongue is more commonly related to nutritional deficiencies like vitamin deficiencies rather than anorexia nervosa.

4. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task of 'Recommend awards and promotions'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: A

Rationale: The correct answer is A: Accountability. The responsibility of 'Recommend awards and promotions' falls under the category of Accountability in personnel management. Accountability involves assessing and acknowledging the performance of individuals, which includes recommending awards and promotions based on merit and achievements. Choices B, C, and D are incorrect because they do not directly relate to the specific task of recommending awards and promotions. Personal/professional development focuses on growth opportunities, individual training relates to skill development, and military appearance/physical condition pertains to different aspects of personnel management that are not directly associated with recommending awards and promotions.

5. A client with type 1 diabetes is diagnosed with diabetic ketoacidosis and initially treated with intravenous fluids followed by an IV bolus of regular insulin. The nurse anticipates that the practitioner will prescribe a continuous infusion of insulin of:

• A. Novolin L insulin
• B. Novolin R insulin
• C. Novolin N insulin
• D. Novolin U insulin

Correct answer: B

Rationale: The correct answer is Novolin R (Regular insulin). Regular insulin is used for continuous infusion to treat diabetic ketoacidosis due to its rapid onset of action. Novolin L (Intermediate-acting insulin) (choice A), Novolin N (Intermediate-acting insulin) (choice C), and Novolin U (Ultra-Long-acting insulin) (choice D) are not suitable for continuous infusion in the treatment of diabetic ketoacidosis.

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