Nursing Elites

1. The nurse is working on an orthopedic rehabilitation unit that requires lifting and positioning of patients. Which personal injury will the nurse most likely try to prevent?

• A. Arm
• B. Hip
• C. Back
• D. Ankle

Correct answer: C

Rationale: The correct answer is C: Back. Back injuries are common among healthcare workers, especially nurses, due to improper lifting techniques and bending. Working on an orthopedic rehabilitation unit involves frequent lifting and positioning of patients, putting the nurse at risk of back injuries. Preventing back injuries is crucial for maintaining the nurse's health and ability to provide care effectively. Choices A, B, and D are incorrect because while lifting and positioning patients may involve these body parts, back injuries are most likely to occur due to the strain and stress placed on the back during such activities.

2. A client with a terminal illness is being cared for by a nurse. Which of the following findings indicates that the client's death is imminent?

• A. Cold extremities
• B. Increased appetite
• C. Elevated blood pressure
• D. Increased level of consciousness

Correct answer: A

Rationale: Cold extremities are a common sign observed in clients nearing death. This occurs due to decreased blood circulation as the body's systems begin to shut down. Cold extremities indicate poor perfusion and reduced function of vital organs. Increased appetite (Choice B) is not typically seen in clients approaching death; instead, a decreased appetite is more common. Elevated blood pressure (Choice C) is not a typical finding in clients nearing the end of life, as blood pressure tends to decrease. An increased level of consciousness (Choice D) is also not indicative of imminent death, as clients near death often experience decreased level of consciousness or become unresponsive.

3. While auscultating a client's abdomen, a nurse hears a blowing sound over the aorta. The nurse should identify this sound as which of the following?

• A. Gallop
• B. Bruit
• C. Thrill
• D. Murmur

Correct answer: B

Rationale: The correct answer is B: Bruit. A bruit is a blowing sound indicating turbulent blood flow, often heard over the aorta. Choices A, C, and D are incorrect. A gallop is a cardiac sound resembling the sound of a galloping horse. A thrill is a vibration felt on palpation, and a murmur is a swooshing or whooshing sound heard during auscultation of the heart or blood vessels. In this scenario, the blowing sound over the aorta specifically indicates a bruit, which signifies turbulent blood flow and should be further assessed by the healthcare provider.

4. What finding signifies that children have attained the stage of concrete operations according to Piaget?

• A. Demonstrates exploration of the environment through sight and movement
• B. Thinks in mental images or word pictures
• C. Makes the moral judgment that 'stealing is wrong'
• D. Reasons that homework is time-consuming yet necessary

Correct answer: C

Rationale: The correct answer is C, 'Makes the moral judgment that 'stealing is wrong''. This finding signifies the attainment of the concrete operational stage according to Piaget. At this stage, children begin to understand rules and logic, including moral judgments. Choice A is incorrect because it does not specifically relate to concrete operational thinking. Choice B is incorrect as it refers more to the preoperational stage where children engage in symbolic thought. Choice D is also incorrect as it involves practical reasoning, which is not directly related to the concrete operational stage according to Piaget.

5. A staff nurse is teaching a newly hired nurse about alternatives to the use of restraints on clients who are confused. Which of the following instructions should the staff nurse include?

• A. Remove clocks from the client’s room
• B. Use full-length side rails on the client’s bed
• C. Check on the client frequently while they are in the restroom
• D. Encourage physical activity throughout the day to expend energy

Correct answer: D

Rationale: Encouraging physical activity throughout the day is an effective way to manage confusion in clients and reduce the need for restraints. Physical activity helps in expending energy, promoting circulation, and improving overall well-being. Removing clocks from the client’s room (choice A) may not directly address the issue of confusion or reduce the need for restraints. Using full-length side rails on the client’s bed (choice B) can actually increase the risk of entrapment and should be avoided. Checking on the client frequently while they are in the restroom (choice C) is important for monitoring safety but may not directly address the underlying issue of confusion and the need for restraints.

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