Nursing Elites

1. The nurse is preparing to provide wound care for a client. Which step should be done first?

• A. Don procedural gloves
• B. Remove the dressing
• C. Apply prescribed medications to the wound
• D. Don a pair of sterile gloves

Correct answer: A

Rationale: The correct answer is to don procedural gloves first. Donning procedural gloves is essential to protect the nurse from contaminants while removing the old dressing. This step helps maintain aseptic technique and prevents the transfer of microorganisms. Removing the dressing (choice B) should follow after wearing gloves to prevent the spread of pathogens. Applying prescribed medications (choice C) should be done after the wound is cleaned and dressed. Donning a pair of sterile gloves (choice D) is not necessary for initial wound care; procedural gloves are sufficient for standard wound care.

2. Which neurotransmitter is most closely associated with mood regulation and is targeted by antidepressants?

• A. Serotonin
• B. Dopamine
• C. GABA
• D. Acetylcholine

Correct answer: A

Rationale: The correct answer is A: Serotonin. Serotonin plays a vital role in mood regulation, and its imbalance is often associated with depression. Many antidepressants function by boosting serotonin levels in the brain. Dopamine (Choice B) is more linked to reward and pleasure pathways in the brain, not primarily targeted for mood regulation. GABA (Choice C) is an inhibitory neurotransmitter that helps reduce neuronal excitability, not primarily associated with mood regulation. Acetylcholine (Choice D) is involved in muscle movement and cognitive functions, not the primary target of antidepressants for mood regulation.

3. A client who is post-operative from a carotid endarterectomy is experiencing difficulty swallowing. What is the nurse's priority action?

• A. Administer a prescribed antiemetic.
• B. Assess the client’s airway and respiratory status.
• C. Elevate the head of the bed.
• D. Encourage the client to take small sips of water.

Correct answer: B

Rationale: The correct answer is to assess the client’s airway and respiratory status (Choice B). Difficulty swallowing after carotid endarterectomy could indicate swelling or nerve damage affecting swallowing, which may compromise the airway. Assessing the airway and respiratory status is crucial to ensure the client's ability to breathe. Administering an antiemetic (Choice A) is not the priority as the primary concern is airway patency. Elevating the head of the bed (Choice C) can help with swallowing difficulties but does not address the immediate risk to the airway. Encouraging the client to take small sips of water (Choice D) is contraindicated if there is a risk of compromised airway due to swallowing difficulties.

4. The nurse is assisting with the admission of a young adult female Korean exchange student with acute abdominal pain. Although the client has been able to easily answer questions, when asked about sexual activity, she looks away. What action should the nurse take?

• A. Omit the section of the assessment form
• B. Ask her if she would like an interpreter to help her understand the question
• C. Reword the question to make it more culturally sensitive
• D. Observe the client's response when asked a different question

Correct answer: D

Rationale: Observing the client's response to another question is the most appropriate action in this scenario. By doing so, the nurse can assess whether the client's discomfort is due to cultural sensitivity or a misunderstanding. This approach allows the nurse to proceed with sensitivity and respect, ensuring effective communication. Option A is incorrect because omitting the section of the assessment form may result in missing crucial information relevant to the client's condition. Option B jumps to assumptions about a language barrier without confirming it first. Option C focuses on rewording the question without addressing the underlying issue causing the client's discomfort, which may not necessarily be due to a lack of understanding.

5. The PN observes a UAP preparing to exit a client's room. The UAP's hands appear visibly soiled as the UAP uses a hand rub for 19 seconds to cleanse the hands. Which action should the PN take?

• A. Confirm that the UAP completed hand hygiene correctly
• B. Instruct the UAP to wash the hands for one minute
• C. Ask the UAP why the hands were so obviously soiled
• D. Advise the UAP to use the hand rub for 30 seconds

Correct answer: D

Rationale: When hands are visibly soiled, they should be washed with soap and water for at least 20 seconds. However, when using hand rub, it should be applied for at least 30 seconds to be effective. In this scenario, the UAP's hands were visibly soiled, indicating the need for thorough cleaning. Advising the UAP to use the hand rub for 30 seconds is essential to ensure proper hand hygiene and reduce the risk of spreading infection. Choices A, B, and C are incorrect because confirming completion of hand hygiene, instructing to wash for one minute, or asking why the hands were soiled do not address the immediate need for proper hand hygiene in the given situation.

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