Nursing Elites

1. The nurse is developing a plan of care for an infant after surgical intervention for imperforate anus. The nurse should include in the plan that which position is the most appropriate one for the infant in the postoperative period?

• A. Prone position
• B. Supine with no head elevation
• C. Side-lying with the legs extended
• D. Supine with the head elevated 45 degrees

Correct answer: A

Rationale: The most appropriate position for an infant after surgical intervention for imperforate anus is the prone position. Placing the infant in a prone position helps keep the hips elevated, reducing edema and pressure on the surgical site. This position promotes optimal healing and comfort for the infant. Option B, supine with no head elevation, does not provide the necessary elevation to reduce pressure on the surgical site. Option C, side-lying with the legs extended, does not offer the same benefits as the prone position in terms of reducing pressure on the surgical site. Option D, supine with the head elevated 45 degrees, does not specifically address the need for hip elevation to prevent pressure on the surgical site. Therefore, the correct choice is the prone position for this postoperative care scenario.

2. The nurse informs the physical therapy department that the client is too weak to use a walker and needs to be transported by wheelchair. Which step of the nursing process is the nurse engaged in at this time?

• A. Assessment
• B. Planning
• C. Implementation
• D. Evaluation

Correct answer: C

Rationale: The nurse is responsible for coordinating the plan of care with other disciplines to ensure the client's safety. This action represents the implementation phase of the nursing process. During the implementation phase, the nurse puts the care plan into action, which includes coordinating with other healthcare team members like the physical therapy department. Assessment involves data gathering, planning involves goal setting, and evaluation involves determining the attainment of client goals.

3. Which of the following is an example of a positive effect of exercise on a client?

• A. Decreased basal metabolic rate
• B. Decreased venous return
• C. Decreased work of breathing
• D. Decreased gastric motility

Correct answer: C

Rationale: The correct answer is 'Decreased work of breathing.' Exercise has numerous positive effects on clients, such as increasing metabolic rate, improving gastric motility, and enhancing venous return. When a client exercises regularly, their work of breathing decreases, meaning that everyday activities require less exertion. This is beneficial as it indicates improved cardiovascular and respiratory efficiency. Choices A, B, and D are incorrect because a decreased basal metabolic rate, decreased venous return, and decreased gastric motility are not typically considered positive effects of exercise. Instead, an increased basal metabolic rate, improved venous return, and optimal gastric motility are desired outcomes associated with physical activity.

4. Which statement by the client with chronic obstructive lung disease indicates an understanding of the major reason for the use of occasional pursed-lip breathing?

• A. ''This action of my lips helps to keep my airway open.''
• B. ''I can expel more air when I pucker up my lips to breathe out.''
• C. ''My mouth doesn't get as dry when I breathe with pursed lips.''
• D. ''By prolonging breathing out with pursed lips, the smaller areas in my lungs don't collapse.''

Correct answer: D

Rationale: The correct answer is D. Clients with chronic obstructive pulmonary disease have difficulty exhaling fully due to the weak alveolar walls from the disease process. Pursed-lip breathing helps prevent alveolar collapse by maintaining positive pressure in the airways during exhalation. This is the major reason for using pursed-lip breathing in individuals with chronic obstructive lung disease. Choices A, B, and C are incorrect because they do not directly address the main purpose of pursed-lip breathing, which is to prevent alveolar collapse and improve exhalation in these patients.

5. Which statement best describes evidence-based practice?

• A. Reading and analyzing research reports to determine their implementation in nursing practice
• B. Collecting data to evaluate the efficiency of nursing practice in delivering quality care
• C. Monitoring unit practices to ensure adherence to Joint Commission standards
• D. Using the most effective, current, and applicable information to guide nursing care for the best outcomes

Correct answer: D

Rationale: Evidence-based practice involves utilizing the most effective, current, and relevant information to inform nursing care decisions for optimal client outcomes. While research reports and data collection are important components of evidence-based practice, the essence lies in integrating all available information to determine the best course of action. Monitoring compliance with standards, as described in choices A and C, is essential for quality assurance but does not capture the comprehensive nature of evidence-based practice.

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