Nursing Elites

1. The nurse is supervising the staff providing care for an 18-month-old hospitalized with hepatitis A. The nurse determines that the staff's care is appropriate if which of the following is observed?

• A. The child is placed in a private room
• B. The staff removes a toy from the child's bed and takes it to the nurse's station
• C. The staff offers the child french fries and a vanilla milkshake for a midafternoon snack
• D. The staff uses standard precautions

Correct answer: A

Rationale: The correct answer is A. Private room placement is crucial when caring for a patient with hepatitis A to prevent the transmission of the disease to others. Placing the child in a private room helps contain the infection and protect other patients and staff. Choices B, C, and D are incorrect because removing a toy from the child's bed, offering specific snacks, or using standard precautions, while important in general care, are not specific measures required to prevent the spread of hepatitis A.

2. A nurse is teaching a client with hypertension about using a blood pressure monitor. Which of the following instructions should the nurse include?

• A. Take your blood pressure after eating
• B. Sit quietly for 5 minutes before taking your blood pressure
• C. Use a blood pressure cuff that is too small
• D. Take your blood pressure while standing

Correct answer: B

Rationale: The correct answer is to instruct the client to sit quietly for 5 minutes before taking their blood pressure. This is important because sitting quietly helps stabilize the heart rate, leading to a more accurate reading. Choice A is incorrect because taking blood pressure after eating can affect the readings. Choice C is wrong because using a blood pressure cuff that is too small can provide inaccurate readings. Choice D is also incorrect as blood pressure should be taken in a seated position for accurate results.

3. A client is undergoing radiation therapy. Which of the following actions should the nurse take to prevent skin irritation?

• A. Apply heat packs to the area
• B. Use perfumed soap to cleanse the area
• C. Keep the area moist with lotion
• D. Avoid sun exposure to the treated area

Correct answer: D

Rationale: Avoiding sun exposure is crucial to prevent skin irritation and burns in clients undergoing radiation therapy. Radiation therapy makes the skin more sensitive to sunlight, increasing the risk of skin damage. Applying heat packs (choice A) can exacerbate skin irritation as heat can further irritate the skin that is already sensitive due to radiation. Using perfumed soap (choice B) can further irritate the skin due to its harsh chemicals, potentially worsening skin reactions. While keeping the area moist with lotion (choice C) may seem beneficial, some lotions contain ingredients that can worsen skin reactions during radiation therapy. Therefore, avoiding sun exposure to the treated area (choice D) is the most appropriate action to prevent skin irritation and damage during radiation therapy.

4. A charge nurse on a long-term care unit is preparing to delegate tasks to a licensed practical nurse (LPN) and an assistive personnel (AP). Which of the following tasks should the charge nurse delegate to the LPN?

• A. Insert an IV catheter
• B. Administer initial NG tube feeding
• C. Administer insulin
• D. Give medications for diabetes

Correct answer: B

Rationale: The correct task to delegate to the LPN is administering initial NG tube feeding. LPNs are trained to carry out this task as it falls within their scope of practice. Inserting an IV catheter (Choice A) is typically performed by registered nurses. Administering insulin (Choice C) and giving medications for diabetes (Choice D) involve assessing the patient's condition and adjusting medication dosage, which are responsibilities of registered nurses or higher-level healthcare providers.

5. A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP?

• A. The roommate is up independently
• B. The client ambulates with his slippers on over his antiembolic stockings
• C. The client uses a front-wheeled walker when ambulating
• D. The client had pain meds 30 minutes ago

Correct answer: C

Rationale: The correct answer is C. After knee arthroplasty, it is essential for the client to use a front-wheeled walker when ambulating to ensure stability and prevent falls. Sharing this information with the assistive personnel (AP) is crucial for the client's safety and proper rehabilitation. Choices A, B, and D are incorrect because the roommate's independence, the client's footwear over stockings, and the timing of pain medication administration are not directly related to the safe ambulation of a client post-knee arthroplasty.

Similar Questions