Nursing Elites

1. The preferred route of administration of medication in the most acute care situations is which of the following routes?

• A. Intravenous C. Subcutaneous
• B. Epidural D. Intramuscular
• C.
• D.

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

2. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

3. You are teaching your clients the difference between Type I (IDDM) and Type II (NDDM) diabetes. Which of the following statements is true?

• A. Both types of diabetes mellitus clients are prone to developing ketosis.
• B. Type II (NIDDM) is more common and preventable compared to Type I (IDDM) diabetes, which is genetic.
• C. Type I (IIDM) is characterized by fasting hyperglycemia.
• D. Type II (NIDDM) is characterized by abnormal immune response.

Correct answer: D

Rationale: The correct answer is D. Type II diabetes (NIDDM) is characterized by insulin resistance and a relative lack of insulin. It is not primarily characterized by an abnormal immune response. Option A is incorrect because only Type I diabetes clients are prone to developing ketosis due to a lack of insulin. Option B is incorrect because while Type II diabetes is more common and often preventable through lifestyle changes, it is not solely genetic. Option C is incorrect because Type I diabetes, not Type II, is characterized by fasting hyperglycemia due to an absolute lack of insulin production.

4. Which is NOT a prudent recommendation for a menopausal patient?

• A. Supplement calcium and vitamin D slightly beyond upper intake level
• B. Encourage lean protein and regular exercise
• C. Avoid alcohol if xerostomia is present
• D. Consumption of 90 mg daily of isoflavones in soy products helps to increase bone mass

Correct answer: A

Rationale: Excessive supplementation of calcium and vitamin D beyond the upper intake level is not recommended unless under medical supervision, as it can cause adverse health effects.

5. When a nurse signs a consent form, which ethical principle is being observed regarding the patient?

• A. Autonomy
• B. Justice
• C. Accountability
• D. Beneficence

Correct answer: A

Rationale: The correct answer is 'Autonomy'. Autonomy refers to the patient's right to make their own decisions, which is being honored when a nurse signs a consent form. While beneficence (Choice D) is an important ethical principle that involves acting in the patient's best interest, it is not what is being primarily observed in this instance. Justice (Choice B) refers to fairness and equal treatment and is not specifically relevant to this scenario. Accountability (Choice C) pertains to being answerable for one's actions and decisions, but again, it is not the principle directly observed in this situation. Therefore, when a nurse signs a consent form, it is the principle of autonomy that is being observed.

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