Nursing Elites

1. Which statement by the patient indicates a need for additional instruction in administering insulin?

• A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
• B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
• C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
• D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'

Correct answer: A

Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.

2. A client who had a stroke resulting in aphasia and dysphagia needs assistance. Which of the following tasks should the nurse assign to an assistive personnel (AP)?

• A. Assist the client with a partial bed bath.
• B. Measure the client's BP after the nurse administers an antihypertensive medication.
• C. Test the client's swallowing ability by providing thickened liquids.
• D. Use a communication board to ask what the client wants for lunch.

Correct answer: A

Rationale: The correct answer is A because assisting the client with a partial bed bath is within the scope of practice for an assistive personnel and does not require specialized medical knowledge. Choice B involves measuring BP, which requires specific training and assessment skills that an assistive personnel may not have. Choice C involves testing swallowing ability, which should be done by a healthcare provider due to the risks involved in dysphagia. Choice D involves communication, which is crucial but should be done by someone with training in managing aphasia to ensure effective communication with the client.

3. A nurse is planning an educational program for a group of older adults at a senior living center. Which of the following recommendations should the nurse include?

• A. You should receive a pneumococcal vaccine when you are 65 years old.
• B. You should receive a shingles vaccine when you are 70 years old.
• C. You should receive a tetanus booster every 5 years.
• D. You should have an eye examination every 2 years.

Correct answer: A

Rationale: The correct answer is A. The CDC recommends a pneumococcal vaccine for all adults aged 65 years and older. This vaccine helps protect against serious pneumococcal disease. Choice B is incorrect as the shingles vaccine is recommended for adults aged 50 years and older, not specifically at 70 years. Choice C is incorrect because a tetanus booster is recommended every 10 years, not every 5 years. Choice D is incorrect as the general recommendation for eye examinations in older adults is annually, not every 2 years.

4. During a staffing crisis, managers may need to use nurse extenders. These individuals are better known as:

• A. Float RNs.
• B. Unlicensed assistive personnel.
• C. LPNs.
• D. Agency nurses.

Correct answer: B

Rationale: During a staffing crisis, managers may need to utilize unlicensed assistive personnel (UAPs) as nurse extenders. UAPs help free up nurses' time, enabling them to focus more on direct client care. Float RNs (Choice A) refer to registered nurses who work in various units as needed, not specifically as nurse extenders during crises. LPNs (Choice C) are licensed practical nurses, not typically used as nurse extenders. Agency nurses (Choice D) are temporary nurses hired from external agencies, not necessarily designated as nurse extenders.

5. A nurse is admitting a client who has an abdominal wound with a large amount of purulent drainage. Which of the following types of transmission precautions should the nurse initiate?

• A. Droplet precautions
• B. Protective environment
• C. Airborne precautions
• D. Contact precautions

Correct answer: D

Rationale: The correct answer is D: Contact precautions. Contact precautions are used when there is a risk of transmission of infections through direct or indirect contact. In this scenario, the client has an abdominal wound with purulent drainage, indicating a potential for infection transmission through contact. Droplet precautions (choice A) are used for infections transmitted through respiratory droplets, such as influenza. Protective environment (choice B) is used for immunocompromised clients. Airborne precautions (choice C) are used for infections transmitted through small droplets that remain in the air, like tuberculosis. Therefore, in this case, the nurse should initiate contact precautions to prevent the spread of infection.

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