Nursing Elites

1. To ensure proper immobilization and increase client comfort when using a rigid splint, what should be done?

• A. Place the client on a stretcher before splinting.
• B. Place the client on a long spine board before splinting.
• C. Pad the spaces between the body part and the splint.
• D. Ensure that the splint conforms to the body curves.

Correct answer: C

Rationale: Correct. When using a rigid splint, it is essential to pad the spaces between the body part and the splint to ensure proper immobilization and increase client comfort. This padding helps prevent pressure points and ensures a proper fit of the splint without causing discomfort. Placing the client on a stretcher or a long spine board before splinting (choices A and B) may be necessary for transportation but does not directly relate to the proper use of a rigid splint. Ensuring that the splint conforms to the body curves (choice D) is important but not as crucial as padding the spaces to prevent discomfort and ensure proper immobilization.

2. The nurse is educating a teenage female about preventing the transmission of genital herpes. Which of the following statements should the nurse include?

• A. "Do not sit on toilet seats without protection."?
• B. "Oral sex can transmit the virus."?
• C. "This infection can be transmitted via intercourse even when you do not feel ill."?
• D. "Try to drink plenty of fluids after sex to flush the reproductive tract."?

Correct answer: C

Rationale: Genital herpes can be transmitted through oral, genital, and anal sex. It is crucial to educate the patient that the infection can be transmitted via intercourse even when asymptomatic to prevent its spread. Choice A is incorrect as sitting on toilet seats without protection does not transmit genital herpes. Choice B is incorrect because oral sex can transmit the virus. Choice D is also incorrect as drinking fluids after sex does not prevent the transmission of genital herpes.

3. When should the biohazard emblem be affixed to containers according to the orientation nurse educator reviewing the biohazard legend with a class of new employees?

• A. when there is presence of blood and body fluids.
• B. when there is the need for droplet precautions.
• C. when there is contact isolation.
• D. when there is the potential for airborne transmission.

Correct answer: A

Rationale: The correct answer is 'when there is presence of blood and body fluids.' When handling body substances like blood and body fluids, the risk of transmission of infections increases. Federal regulations mandate warning labels on containers to alert employees and waste collectors. The biohazard emblem consists of a three-ring symbol overlaying a central concentric ring. Blood, wound drainage, feces, and urine are examples of body fluids that can transmit infections and diseases to others. The other choices, B, C, and D, are incorrect because the presence of the biohazard emblem is specifically linked to the handling of blood and body fluids, not to droplet precautions, contact isolation, or airborne transmission.

4. When planning task assignments for five clients on the skilled nursing unit in a long-term care facility, which task should a licensed practical nurse (LPN) assign to another LPN?

• A. Bathing a client who is confused and requires assistance with a shower
• B. Administering regular insulin in accordance with a sliding-dosage scale every 4 hours to a client with diabetes mellitus
• C. Assisting a client requiring a bed bath and frequent ambulation with a cane
• D. Transporting a client who must be accompanied to physical therapy twice during the shift

Correct answer: B

Rationale: When assigning tasks, the nurse must consider the skills and educational level of the nursing staff. The nursing assistant may be assigned tasks like caring for a confused client, assisting with a shower or a bed bath, ambulating a client with a cane, and accompanying a client to physical therapy. The LPN is educated to administer medications like regular insulin in accordance with a sliding scale. This task requires a higher level of training and knowledge than the tasks that can be delegated to a nursing assistant. Administering insulin involves assessing blood glucose levels, calculating dosages, and understanding the effects of insulin therapy on the client's condition. Therefore, the correct answer is administering regular insulin to a client with diabetes mellitus. Choices A, C, and D involve tasks that are within the scope of practice of a nursing assistant, not an LPN.

5. Which direction given to the nursing assistant is most likely to accomplish the task of getting a urine specimen delivered to the lab immediately after collection?

• A. "Make it a stat delivery."?
• B. "Please do it as soon as you can after break."?
• C. "This client is delirious, and we're worried about urinary sepsis."?
• D. "Take this client to the bathroom now and collect a urine specimen from this voiding. Take the specimen to the lab immediately."?

Correct answer: D

Rationale: Effective delegation depends on clear, concise direction that leaves no room for question or interpretation on the part of the one being delegated to. In this scenario, the most appropriate direction is to ensure the urine specimen is collected promptly and delivered to the lab immediately. Choice A is too vague and does not specify the urgency required. Choice B does not emphasize the immediate need for the specimen to be delivered. Choice C introduces unnecessary medical information that is beyond the scope of a nursing assistant and may cause confusion. Therefore, choice D is the correct answer as it provides clear instructions for immediate action without room for misunderstanding.

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