Nursing Elites

1. Which is the proper hand position for performing chest vibration?

• A. cup the hands
• B. use the side of the hands
• C. flatten the hands
• D. spread the fingers of both hands

Correct answer: C

Rationale: The correct hand position for performing chest vibration is to flatten the hands. By flattening the hands over the area of the body where chest percussion is applied, vibrations can be conducted effectively to the chest to help loosen secretions. Cupping the hands may dampen vibrations, using the side of the hands reduces the surface area in contact with the chest, and spreading the fingers can lead to uneven pressure distribution. Therefore, flattening the hands provides the necessary contact and surface area to perform chest vibration efficiently.

2. The mother of a child who weighs 45 lb asks a nurse about car safety seats. The nurse tells the mother to place the child in which car safety seat?

• A. Car safety seat in the back seat in a face-forward position
• B. Booster seat with one of the car's seat belts placed over the child
• C. Booster seat in a rear-facing position in the front seat
• D. Car safety seat in a face-forward position in the front seat

Correct answer: B

Rationale: The correct answer is to place the child in a booster seat with one of the car's seat belts placed over the child. A child needs to remain in a car safety seat until he or she weighs 40 lb. Once the child has outgrown the car safety seat, a booster seat is used. Booster seats are designed to raise the child high enough so that the restraining straps are correctly positioned over the child's chest and pelvis, providing optimal safety. Placing a child in a booster seat in a rear-facing position in the front seat is incorrect as children should not be seated in the front seat due to potential airbag-related injuries. Additionally, car safety seats are used for children weighing less than 40 lb and are placed in the middle of the back seat in a rear-facing position for maximum protection.

3. When are standard walkers typically used?

• A. When clients have poor balance, cannot stand up, have weak arms, and good hand strength.
• B. When clients have poor balance, have a broken leg, or have experienced amputation.
• C. When clients have poor balance, have cardiac problems, or cannot use crutches or a cane.
• D. When clients have poor balance, have an autoimmune disease, or have weak arms.

Correct answer: C

Rationale: Standard walkers are typically used for clients who have poor balance, cardiac problems, or those who cannot use crutches or a cane. The rationale is correct in stating that a walker is suitable for individuals needing to bear partial weight and having strength in their wrists and arms to propel the walker forward. Choices A, B, and D are incorrect because they do not accurately reflect the main reasons why standard walkers are used in clinical practice. Using a walker is not solely about having weak arms, good hand strength, a broken leg, experienced amputation, or an autoimmune disease. The primary focus is on addressing balance issues, cardiac problems, or the inability to use crutches or a cane effectively.

4. Quality is defined as a combination of all of the following except:

• A. conforming to standards.
• B. performing at the minimally acceptable level.
• C. meeting or exceeding customer requirements.
• D. exceeding customer expectations.

Correct answer: B

Rationale: Quality in any context is about meeting or exceeding customer requirements and exceeding customer expectations. It also involves conforming to standards to ensure consistency and reliability. Merely performing at the minimally acceptable level does not encompass the essence of quality, as it sets the bar at the lowest level of acceptability rather than aiming for excellence or customer satisfaction. Therefore, the correct answer is 'performing at the minimally acceptable level,' as this choice falls short in capturing the comprehensive definition of quality.

5. When preparing a client for a neck x-ray, what is the most appropriate action for the nurse to take if the client expresses concern about removing a religious medal worn around the neck?

• A. Telling the client that the medal and chain will be kept at the nurse's station for safekeeping while the client is undergoing the x-ray
• B. Asking the client to remove the medal until the x-ray has been completed
• C. Assisting the client in pinning the medal and chain to the waistband of the client's pajama bottoms
• D. Asking the client to place the medal in the top drawer of the bedside stand just before leaving for the radiology department

Correct answer: C

Rationale: When a client undergoing a neck x-ray expresses concern about removing a religious medal worn around the neck, the nurse should assist the client in pinning the medal and chain to the hospital gown or in another area where it will not appear on the x-ray image. This action allows the client to keep the medal close without interfering with the x-ray procedure. It is important to ensure that the radiology department staff is informed about this arrangement. Asking the client to remove the medal, keeping it at the nurse's station, or placing it in the bedside stand is not appropriate. These actions may lead to the loss of the medal and chain and do not address the client's concerns about the religious significance of the item.

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