Nursing Elites

1. The PN is assisting the recreational director of a long-term care facility to plan outdoor activities for wheelchair-bound older residents who are mentally alert. Which activity meets the physical and social needs of these residents?

• A. An open-air concert
• B. A tea party in the courtyard
• C. A team ring-toss competition
• D. A picnic in the park

Correct answer: B

Rationale: A tea party in the courtyard is the most suitable activity as it allows for social interaction in a comfortable and accessible environment. Wheelchair-bound residents can easily participate, fostering both physical and social engagement. An open-air concert may pose challenges regarding accessibility and comfort for wheelchair-bound individuals. A team ring-toss competition involves physical activity that may not be inclusive for all residents, especially those in wheelchairs. A picnic in the park may also present challenges related to accessibility and comfort for wheelchair-bound individuals.

2. A client with a chest tube following a pneumothorax is concerned about the continuous bubbling in the water seal chamber. What should the nurse explain to the client?

• A. Continuous bubbling in the water seal chamber indicates an air leak.
• B. Continuous bubbling is normal and expected with a chest tube.
• C. Bubbling will stop when the lung has fully expanded.
• D. The nurse should notify the healthcare provider immediately.

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber of a chest tube system indicates an air leak. An air leak can prevent the lung from fully re-expanding and may lead to complications like a recurrent pneumothorax. Therefore, it is crucial to investigate and address the air leak promptly. Choices B and C are incorrect because continuous bubbling is not normal and does not indicate lung expansion. Choice D is incorrect because the nurse should first assess and then report the issue to the healthcare provider.

3. Which type of isolation precaution is required for a patient with tuberculosis (TB)?

• A. Droplet precautions
• B. Contact precautions
• C. Airborne precautions
• D. Standard precautions

Correct answer: C

Rationale: The correct answer is C: Airborne precautions. Tuberculosis (TB) is transmitted via airborne particles, thus requiring airborne precautions to prevent the spread of infection. This includes using an N95 respirator to filter out small infectious particles. Droplet precautions (Choice A) are used for diseases that spread through large respiratory droplets. Contact precautions (Choice B) are for direct or indirect contact with the patient or their environment. Standard precautions (Choice D) are used for all patients to prevent the spread of infection through blood, bodily fluids, non-intact skin, and mucous membranes.

4. A client who is post-operative from a bowel resection is experiencing abdominal distention and pain. The nurse notices the client has not passed gas or had a bowel movement. What should the nurse assess first?

• A. The client's bowel sounds.
• B. The client's fluid intake.
• C. The client's pain level.
• D. The client's surgical incision.

Correct answer: A

Rationale: Assessing bowel sounds is crucial in this situation as it helps determine if the client's gastrointestinal tract is functioning properly. Absent or hypoactive bowel sounds can indicate an ileus, a common post-operative complication. Assessing fluid intake (Choice B) is important but should come after assessing bowel sounds. Pain assessment (Choice C) is essential but addressing the physiological issue should take precedence. Checking the surgical incision (Choice D) is relevant but not the priority when the client is experiencing abdominal distention and potential gastrointestinal complications.

5. The mother of a 9-month-old child diagnosed with respiratory syncytial virus (RSV) yesterday calls the clinic to inquire if it will be all right to take her infant to a friend's child's first birthday party the following day. Which response should the nurse provide?

• A. Do not expose other children as the virus is very contagious even without direct contact
• B. The child will no longer be contagious, no need to take any further precautions
• C. The child can be around other children but should wear a mask
• D. Make sure there are no children under the age of 5 months around the infected child

Correct answer: A

Rationale: The correct response is A: 'Do not expose other children as the virus is very contagious even without direct contact.' RSV is highly contagious, especially in young children. Allowing the infected child to attend a birthday party can put other children at risk of contracting the virus. Choice B is incorrect as RSV can remain contagious for a period of time. Choice C is not sufficient, as wearing a mask may not entirely prevent the spread of the virus. Choice D is inaccurate, as children under 5 months are not the only ones susceptible to RSV; all young children are at risk.

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