Nursing Elites

1. What is the number one reason a person with alcohol addiction does not seek treatment?

• A. Co-dependency
• B. Denial
• C. Depression
• D. Stigma

Correct answer: B

Rationale: The correct answer is B: Denial. Individuals with alcohol addiction often deny that they have a drinking problem and may become defensive when confronted about it. This sense of denial can be a significant barrier to seeking treatment. Co-dependency, referred to in choice A, is a relationship dynamic and is not the primary reason for avoiding treatment. Depression, as mentioned in choice C, is a common co-occurring condition with alcohol addiction but is not typically the main factor preventing treatment-seeking. Stigma, as in choice D, can act as a deterrent, but denial of the problem itself is usually the primary obstacle to seeking help.

2. Which electrolyte imbalance would be the nurse's priority concern in the burn client?

• A. Hypernatremia
• B. Hyperkalemia
• C. Hypoalbuminemia
• D. Hypermagnesemia

Correct answer: B

Rationale: The correct answer is hyperkalemia. In a burn client, the nurse's priority concern is hyperkalemia due to cell lysis, which releases potassium into the bloodstream. This can lead to dangerous levels of potassium in the blood. Hypernatremia (Choice A) is less likely in burn clients. Hypoalbuminemia (Choice C) can occur but is not the priority in the immediate management of a burn client. Hypermagnesemia (Choice D) is not typically associated with burn injuries.

3. What task should the RN perform first?

• A. Changing a burn dressing that is scheduled every four hours.
• B. Doing pinsite care on a client in skeletal traction ordered TID.
• C. Teaching a newly diagnosed diabetic about diet and exercise.
• D. Assessing a newly admitted client.

Correct answer: D

Rationale: The correct answer is to assess a newly admitted client first. When a client is newly admitted, it is crucial to perform an assessment promptly. The initial assessment and establishment of a care plan should be completed within a specific timeframe to ensure the client's needs are met effectively. Choices A, B, and C involve important tasks but should be prioritized after the initial assessment of the newly admitted client to ensure timely and appropriate care delivery. Changing a burn dressing (Choice A) and doing pinsite care on a client in skeletal traction (Choice B) are time-sensitive tasks but can be safely delayed briefly to conduct the initial assessment. Teaching a newly diagnosed diabetic about diet and exercise (Choice C) is important for the client's long-term care but can be scheduled after the immediate needs assessment of the newly admitted client.

4. Which behavior by a new nurse would indicate to the charge nurse that this nurse is following standard precautions?

• A. Wearing clean gloves while performing a heel stick on an infant
• B. Wearing the same gloves for assessments of clients in the same room
• C. Wearing sterile gloves when changing the urine bag and nasogastric canister of an infected client
• D. Donning a gown when responding to a request by the family to check the IV pump on a client with rotavirus

Correct answer: A

Rationale: The correct answer is wearing clean gloves while performing a heel stick on an infant. Standard precautions require the use of gloves when there is a risk of exposure to blood or body fluids. Clean gloves are suitable for this task as they provide adequate protection without being sterile. Choice B is incorrect because wearing the same gloves for different clients can lead to cross-contamination, violating standard precautions. Choice C is incorrect as sterile gloves are usually not required for changing a urine bag and nasogastric canister unless a specific aseptic technique is indicated; standard precautions do not demand sterile gloves for such tasks. Choice D is incorrect as donning a gown is not necessary for checking an IV pump unless there is a risk of exposure to bodily fluids that would necessitate full-body protection, which is not indicated in this scenario.

5. A 46-year-old has returned from a heart catheterization and wants to get up to start walking 3 hours after the procedure. The nurse should:

• A. Tell the patient to remain with the leg straight for at least another hour and check the chart for activity orders.
• B. Allow the patient to begin limited ambulation with assistance.
• C. Recommend a physical therapy consultation for ambulation.
• D. Tell the patient to remain with the leg straight for another 6 hours and check the chart for activity orders.

Correct answer: A

Rationale: The correct answer is to tell the patient to remain with the leg straight for at least another hour after a heart catheterization before starting ambulation. This period allows for proper healing and reduces the risk of complications such as bleeding or hematoma formation at the catheter insertion site. Starting ambulation too soon can disrupt the healing process and lead to adverse events. Choice B is incorrect because limited ambulation should not be initiated shortly after the procedure as it may increase the risk of complications. Choice C is incorrect as physical therapy consultation is not typically necessary for initial ambulation post-heart catheterization; this can be managed by nursing staff. Choice D is incorrect as keeping the leg straight for 6 hours is excessive and unnecessary, potentially leading to complications such as deep vein thrombosis due to prolonged immobility.

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