Nursing Elites

1. What is the priority nursing intervention for a patient with a new tracheostomy?

• A. Suction the tracheostomy as needed to maintain a patent airway.
• B. Monitor the patient's oxygen saturation.
• C. Provide humidified air to prevent drying of the airway.
• D. Administer pain medication as prescribed.

Correct answer: A

Rationale: The correct answer is to suction the tracheostomy as needed to maintain a patent airway. After a tracheostomy procedure, the immediate concern is airway patency to prevent respiratory compromise. Suctioning helps clear secretions and maintains a clear airway, reducing the risk of respiratory distress. Monitoring the patient's oxygen saturation (choice B) is important but not the priority compared to ensuring a clear airway. Providing humidified air (choice C) and administering pain medication (choice D) are also essential aspects of care for a patient with a tracheostomy, but they are not the priority when immediate airway management is required.

2. The nurse is evaluating a client who had a cardiac catheterization with a left antecubital insertion site. Which of the following pulses should the nurse palpate?

• A. Brachial pulse in the right arm
• B. Radial pulse in the right arm
• C. Brachial pulse in the left arm
• D. Radial pulse in the left arm

Correct answer: D

Rationale: The correct answer is to palpate the radial pulse in the left arm. When the antecubital insertion site is on the left side, it is important to assess the radial pulse on the same side to monitor circulation accurately. Palpating the brachial pulse in the right or left arm or the radial pulse in the right arm would not provide direct information about the circulation related to the catheterization site.

3. A nurse manager notices a discrepancy in a nurse's narcotics record. What is the appropriate action?

• A. Ask the nurse for clarification about the record.
• B. Report the discrepancy to the pharmacy.
• C. Report the issue to the nurse manager immediately.
• D. Ignore the discrepancy as a clerical error.

Correct answer: B

Rationale: The appropriate action when a nurse manager notices a discrepancy in a nurse's narcotics record is to report the discrepancy to the pharmacy. Reporting such discrepancies is crucial to ensure accountability and patient safety. Choice A is incorrect because the nurse manager should not confront the nurse directly without proper investigation. Choice C is incorrect because reporting to the nurse manager may not address the issue effectively. Choice D is incorrect because ignoring the discrepancy can compromise patient safety and violates protocols.

4. Which of the following is an example of professional negligence?

• A. Following facility guidelines at all times
• B. Using equipment in a knowledgeable manner
• C. Communicating effectively with clients
• D. Documenting client interactions accurately

Correct answer: A

Rationale: Professional negligence involves failing to meet the standard of care expected in a particular profession, which can lead to harm. In this case, not following facility guidelines can result in lapses in safety or quality of care, potentially causing harm to clients. Choices B, C, and D all represent essential aspects of professional conduct and do not directly relate to negligence.

5. What is the priority when assessing a patient for possible deep vein thrombosis (DVT)?

• A. Dorsiflex the foot and check for pain.
• B. Measure the calf circumference of both legs.
• C. Check the skin for signs of redness.
• D. Perform a Doppler ultrasound scan.

Correct answer: B

Rationale: The correct answer is to measure the calf circumference of both legs when assessing a patient for possible DVT. An increase in calf circumference in one leg can indicate the presence of a DVT. Option A is incorrect because dorsiflexing the foot and checking for pain are not primary assessments for DVT. Option C is incorrect as redness of the skin may not always be present in cases of DVT. Option D is incorrect as performing a Doppler ultrasound scan is usually done after clinical assessment and to confirm the diagnosis, not as the initial priority assessment.

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