Nursing Elites

1. What will ensure the safe movement of a patient who is unable to move and needs to be pulled up in bed?

• A. Place the pillow under the patient's head and shoulders.
• B. Attempt to do it alone if the bed is in a flat position.
• C. Place the side rails in the up position.
• D. Use a friction-reducing device.

Correct answer: D

Rationale: To ensure the safe movement of a patient who is unable to move and needs to be pulled up in bed, it is essential to use a friction-reducing device. This device helps reduce the risk of injury to both the patient and the healthcare provider by minimizing the effort required to reposition the patient. Placing a pillow under the patient's head and shoulders (Choice A) may provide comfort but does not address the safety concerns associated with moving the patient. Attempting to move the patient alone (Choice B) is not recommended as it can lead to injuries for both the patient and the healthcare provider. Placing the side rails in the up position (Choice C) may not directly contribute to the safe movement of the patient in this scenario.

2. Under the provisions of the Americans with Disabilities Act, what are nurse managers required to do?

• A. Maintain an environment free from associated hazards
• B. Provide reasonable accommodations for disabled individuals
• C. Make all necessary accommodations for disabled individuals
• D. Consider both mental and physical disabilities

Correct answer: B

Rationale: The correct answer is B: 'Provide reasonable accommodations for disabled individuals.' The Americans with Disabilities Act (ADA) mandates nurse managers to offer reasonable accommodations for disabled individuals to ensure equal opportunities in the workplace. Choice A is incorrect because although maintaining a hazard-free environment is essential, the focus of the ADA is on accommodations for disabled individuals. Choice C is incorrect as it overly generalizes the accommodations without specifying the need for them to be 'reasonable.' Choice D is incorrect because the ADA does not specify a requirement to consider both mental and physical disabilities; instead, it emphasizes providing reasonable accommodations regardless of the disability type.

3. The charge nurse on the unit observes that one of the staff nurses is not using proper hand washing techniques. Which is the most appropriate initial approach to correct the behavior?

• A. Remind the nurse that proper hand washing prevents infection
• B. Discuss what the nurse knows about proper hand hygiene
• C. Provide a review of the hand washing policy
• D. Refer the nurse to the infection control nurse

Correct answer: B

Rationale: The most appropriate initial approach to correct the behavior of improper hand washing by a staff nurse is to discuss what the nurse knows about proper hand hygiene. This approach helps in identifying any knowledge gaps the nurse may have and provides an opportunity to educate and correct the behavior. Option A is not the best choice as simply reminding the nurse about the importance of hand washing may not address the underlying issue of knowledge or technique. Option C, providing a review of the hand washing policy, may be necessary but is not the most immediate step to take. Option D, referring the nurse to the infection control nurse, is premature and may not be necessary if the issue can be resolved through education and communication first.

4. The nurse is assessing body alignment for a patient who is immobilized. Which patient position will the nurse use?

• A. Supine position
• B. Lateral position
• C. Lateral position with positioning supports
• D. Supine position with no pillow under the patient's head

Correct answer: B

Rationale: When assessing body alignment for an immobilized patient, the nurse should use the lateral position. This position helps in assessing alignment and preventing complications such as pressure ulcers. The supine position (Choice A) may not provide an accurate assessment of body alignment in an immobilized patient. While a lateral position with positioning supports (Choice C) may be used for comfort, it is not specifically for assessing body alignment. Using the supine position without a pillow under the patient's head (Choice D) is not ideal for assessing body alignment in an immobilized patient as it may not accurately reflect the patient's overall alignment.

5. A client has restraints on each extremity. Which of the following assessments should the nurse perform first?

• A. Peripheral pulses
• B. Comfort level
• C. Elimination needs
• D. Skin integrity

Correct answer: A

Rationale: When a client is restrained, the nurse should prioritize assessing peripheral pulses first. This assessment is crucial to monitor circulation and ensure the restraints are not impeding blood flow. Comfort level, elimination needs, and skin integrity are also important assessments; however, assessing peripheral pulses takes precedence to prevent complications such as impaired circulation and tissue damage. By assessing peripheral pulses initially, the nurse can promptly identify and address any circulation issues, which are critical in preventing serious complications.

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