Nursing Elites

1. When choosing a needle gauge for an intramuscular injection in a 12-year-old boy, which of the following gauges would you choose?

• A. 27 gauge
• B. 25 gauge
• C. 22 gauge
• D. 20 gauge

Correct answer: C

Rationale: The correct answer is 22 gauge. A 22-gauge needle is recommended for school-age children, toddlers, and adolescents due to their muscle mass and tolerance. In infants, a smaller gauge (23-25) is preferred as their muscles are less developed and more sensitive. Choice A, 27 gauge, is too thin for an intramuscular injection in a 12-year-old boy. Choice B, 25 gauge, is more suitable for infants than for a 12-year-old. Choice D, 20 gauge, is too thick and not typically used for intramuscular injections in children.

2. What is the most effective strategy to assist a client in recognizing and using personal strength?

• A. Encouraging the client's self-identification of strengths.
• B. Promoting the client's active external thinking.
• C. Listening to the client and providing advice as needed.
• D. Assisting the client in maintaining an external locus of control.

Correct answer: A

Rationale: Encouraging the client to identify their own strengths is empowering and helps build self-awareness and self-confidence. This strategy promotes autonomy and self-efficacy, enabling the client to recognize and utilize their personal strengths effectively. Option B, promoting the client's active external thinking, is vague and not directly related to recognizing personal strengths. Option C, listening to the client and providing advice as needed, focuses more on the nurse's role rather than empowering the client to recognize their strengths independently. Option D, assisting the client in maintaining an external locus of control, goes against the goal of helping the client recognize and utilize their internal strengths.

3. The charge nurse is observing a student nurse caring for a 4-month-old infant in isolation diagnosed with RSV. Which of the following would indicate to the charge nurse that the student nurse needs further instruction on isolation standards?

• A. Donning clean gloves each time she goes in the room.
• B. Wearing a clean mask each time she goes in the room.
• C. Labeling the door so staff will use Airborne Precautions.
• D. Wearing a gown when she goes in the room to administer medication.

Correct answer: A

Rationale: The correct answer is 'Donning clean gloves each time she goes in the room.' Sterile gloves are not necessary for standard isolation precautions; clean gloves are sufficient. The student nurse should be instructed to use clean gloves to reduce the risk of spreading infections. Wearing a clean mask each time she goes in the room is a good practice to prevent the spread of respiratory infections like RSV. Labeling the door for Airborne Precautions is appropriate for RSV. Wearing a gown when entering the room to administer medication helps prevent the transmission of infectious agents.

4. A child with newly diagnosed leukemia is receiving chemotherapy. Which would be included in his plan of care by the nurse?

• A. Place the child in a negative pressure isolation room
• B. Administer prophylactic IV antibiotics
• C. Avoid high protein food intake
• D. Teach family and visitors handwashing techniques

Correct answer: D

Rationale: The correct answer is to teach family and visitors handwashing techniques. Any client on chemotherapy should have good infection control measures in place, such as handwashing by all who they encounter. Placing the child in a negative pressure isolation room (Choice A) is not necessary unless specifically indicated for a certain condition. Administering prophylactic IV antibiotics (Choice B) may not be part of the standard care plan for a child with leukemia receiving chemotherapy. Avoiding high protein food intake (Choice C) is not directly related to infection control and may not be necessary unless there are specific dietary restrictions.

5. The nurse is caring for a client complaining of intense headaches with increasing pain for the past one month. An MRI is ordered. In reviewing the client's information, which piece of information is of concern?

• A. Allergy to shellfish
• B. Has a cardiac pacemaker
• C. A diabetic
• D. No IV access

Correct answer: B

Rationale: The correct answer is 'Has a cardiac pacemaker.' If a client with a cardiac pacemaker undergoes an MRI, the magnetic field can interfere with the pacemaker's function, leading to serious complications or even death. It is crucial to ensure that the pacemaker is compatible with MRI imaging or to consider alternative imaging modalities. The other choices, such as 'Allergy to shellfish,' 'A diabetic,' and 'No IV access,' are not direct contraindications for an MRI scan and do not pose the same level of risk as having a cardiac pacemaker.

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