Nursing Elites

1. To use proper body mechanics while making an occupied bed for a client on bed rest, the nurse should:

• A. Place the bed in a high horizontal position
• B. Use a low bed position
• C. Bend at the waist
• D. Keep the bed flat and at a comfortable working height

Correct answer: A

Rationale: When making an occupied bed for a client on bed rest, the nurse should place the bed in a high horizontal position to promote better body mechanics. This positioning helps reduce strain on the nurse's back and promotes proper alignment while working. Using a low bed position can lead to awkward bending and increased risk of musculoskeletal injuries. Bending at the waist is discouraged as it can strain the back. Keeping the bed flat and at a comfortable working height may not provide the optimal ergonomic setup needed to prevent injury.

2. A healthcare professional is providing care to a client who has a tracheostomy. Which of the following actions should the professional take to prevent complications?

• A. Clean around the stoma with povidone-iodine.
• B. Maintain sterile technique when performing tracheostomy care.
• C. Use clean technique when suctioning the tracheostomy.
• D. Change tracheostomy ties weekly.

Correct answer: B

Rationale: Maintaining sterile technique when performing tracheostomy care is essential in preventing infections and complications. Option A is incorrect because povidone-iodine may be too harsh for cleaning around the stoma and can lead to skin irritation. Option C is incorrect because suctioning a tracheostomy should be done using sterile technique to minimize the risk of introducing pathogens. Option D is incorrect as tracheostomy ties need to be changed more frequently, usually every 1-2 days, to prevent skin breakdown and infection.

3. The healthcare provider is caring for a client with a wound infection. Which type of dressing is most appropriate to use to promote healing by secondary intention?

• A. Dry gauze dressing
• B. Wet-to-dry dressing
• C. Transparent film dressing
• D. Hydrocolloid dressing

Correct answer: D

Rationale: Hydrocolloid dressings are ideal for promoting healing by secondary intention in wound infections. These dressings create a moist environment that supports autolytic debridement and facilitates the healing process. Dry gauze dressings (Option A) may lead to adherence, causing trauma upon removal and disrupting the wound bed. Wet-to-dry dressings (Option B) are primarily used for mechanical debridement and can be painful during dressing changes. Transparent film dressings (Option C) are more suitable for superficial wounds with minimal exudate and are not typically used for wound infections requiring healing by secondary intention.

4. A group of newly licensed nurses is being taught about the Braden Scale by a nurse. Which of the following responses by a newly licensed nurse indicates an understanding of the teaching?

• A. “The client’s age is not a factor in the measurement.”
• B. “The scale measures six elements.”
• C. “A lower score indicates a higher risk of pressure ulcers.”
• D. “Each element is scored on a range from 1 to 4 points.”

Correct answer: B

Rationale: Choice B is the correct answer because the Braden Scale measures six elements: Sensory Perception, Moisture, Activity, Mobility, Nutrition, Friction, and Shear. The other choices are incorrect because: Choice A states that the client's age is not a factor in the measurement, which is accurate as age is not included in the Braden Scale. Choice C incorrectly states that a lower score indicates a higher risk of pressure ulcers, which is the opposite of how the Braden Scale works. Choice D inaccurately describes the scoring range of each element on the Braden Scale, which is not from 1 to 4 points but rather from 1 to 3.

5. A client had a mastectomy 6 months ago and expresses a decreased desire for sexual relations, stating “My body is so different now.” Which of the following responses should the nurse make?

• A. “Really, you look just fine to me. There’s no need to feel undesirable.”
• B. “I’m interested in finding out more about how your body feels to you.”
• C. “Consider an afternoon at a spa; a facial will make you feel more attractive.”
• D. “It’s still too soon to expect to feel normal. Give it a little more time.”

Correct answer: B

Rationale: In this situation, the appropriate response is to reflect on the client’s feelings and explore their experience. Choice A may unintentionally dismiss the client's concerns by not addressing their emotional needs. Choice C suggests a spa treatment as a solution without addressing the underlying emotional issues. Choice D implies that the client's feelings will resolve with time, which may not be helpful in addressing the client's current emotional state.

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