Nursing Elites

1. The patient has been in bed for several days and needs to be ambulated. What action should the nurse take first?

• A. Dangle the patient at the bedside.
• B. Encourage isometric exercises.
• C. Suggest a high-calcium diet.
• D. Maintain a narrow base of support.

Correct answer: A

Rationale: The correct answer is A: 'Dangle the patient at the bedside.' When a patient has been in bed for an extended period and needs to be ambulated, it is essential to dangle the patient at the bedside first. Dangling involves helping the patient sit on the edge of the bed with their legs over the side before standing up. This action helps prevent orthostatic hypotension, a sudden drop in blood pressure when moving from lying down to standing up, which can lead to dizziness or fainting. Encouraging isometric exercises (choice B) or suggesting a high-calcium diet (choice C) are not the first actions to take before ambulating a patient. Maintaining a narrow base of support (choice D) is related to assisting with ambulation but is not the initial step that should be taken.

2. A nurse is caring for a client who is in labor and has an external fetal monitor in place. The nurse observes late decelerations in the fetal heart rate. Which of the following actions should the nurse take first?

• A. Decrease the client's IV fluids
• B. Reposition the client
• C. Administer oxygen by face mask
• D. Document the findings

Correct answer: C

Rationale: Administering oxygen by face mask is the priority intervention when late decelerations are observed in the fetal heart rate. Late decelerations indicate uteroplacental insufficiency, and administering oxygen helps to improve fetal oxygenation. Repositioning the client may also be necessary to relieve pressure on the umbilical cord, but providing oxygen takes precedence to enhance fetal oxygenation. Decreasing IV fluids may not directly address the underlying issue leading to late decelerations. Documenting the findings is important but should not be the first action taken when managing late decelerations.

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

Correct answer: B

Rationale: The correct answer is B: Back. Back injuries are most common during lifting and bending tasks, especially in an orthopedic unit. When lifting or repositioning patients, nurses must prioritize proper body mechanics to prevent strain on the back. Choices A, C, and D are less likely to occur as frequently as back injuries in this scenario because of the nature of the tasks involved in orthopedic patient care.

4. A healthcare professional suspects a colleague of diverting narcotics. What is the first step the healthcare professional should take?

• A. Confront the colleague directly
• B. Report the suspicion to the supervisor
• C. Ignore the issue and continue working
• D. Notify the pharmacy about the colleague's behavior

Correct answer: B

Rationale: The correct first step for a healthcare professional who suspects a colleague of diverting narcotics is to report the suspicion to the supervisor. This action is essential to protect patient safety, uphold ethical standards, and comply with legal obligations. Confronting the colleague directly may not only escalate the situation but also jeopardize the investigation process. Ignoring the issue and continuing to work could potentially harm patients and violate professional responsibilities. Notifying the pharmacy, while important, should come after informing the appropriate supervisor or authority within the healthcare facility.

5. A healthcare provider is assessing a client who has carpal tunnel syndrome. The provider should expect which of the following findings?

• A. Positive Chvostek's sign
• B. Cool extremities
• C. Positive Phalen's sign
• D. Decreased radial pulse

Correct answer: C

Rationale: Phalen's sign is often positive in clients with carpal tunnel syndrome due to nerve compression. Chvostek's sign (Choice A) is related to hypocalcemia, cool extremities (Choice B) are not typically associated with carpal tunnel syndrome, and decreased radial pulse (Choice D) is not a common finding in carpal tunnel syndrome.

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