Nursing Elites

1. When caring for clients with Buck’s Traction, the major areas of importance should be:

• A. nutrition, elimination, comfort, safety
• B. ROM exercises, transportation
• C. nutrition, elimination, comfort, safety
• D. elimination, safety, isotonic exercises

Correct answer: C

Rationale: When caring for clients with Buck’s Traction, the major areas of importance should be nutrition, elimination, comfort, and safety. Proper nutrition, including a diet high in protein with adequate fluids, is essential for healing and recovery. Elimination refers to maintaining regular bowel and bladder function. Comfort is crucial to ensure the patient's well-being while in traction, and safety measures should be followed to prevent complications. Choices A, B, and D are incorrect. ROM exercises are not typically a primary concern with Buck’s Traction, making choices A and B incorrect. Isotonic exercises are not specifically related to the care of a client in Buck's Traction, making choice D incorrect.

2. Ethical and moral issues concerning restraints include all of the following except:

• A. emotional impact on the client and family.
• B. dignity of the client.
• C. client's quality of life.
• D. policies and procedures.

Correct answer: D

Rationale: The correct answer is 'policies and procedures.' While policies and procedures are essential for managing restraints, they are not in themselves ethical or moral issues. The emotional impact on the client and family, the dignity of the client, and the client's quality of life are all ethical and moral concerns related to the use of restraints. These aspects focus on the well-being, respect, and rights of the individual, which are fundamental ethical considerations in healthcare practice. Choices A, B, and C are directly tied to ethical and moral considerations by highlighting the impact on individuals involved and their overall quality of life and dignity, making them key factors to address in ethical decision-making.

3. All of the following are causes of vaginal bleeding in late pregnancy except:

• A. Placenta previa.
• B. Eclampsia.
• C. Abruptio placentae.
• D. Uterine rupture.

Correct answer: B

Rationale: The correct answer is B: Eclampsia. Eclampsia is a disorder of pregnancy characterized by hypertension, proteinuria, and edema. This condition can cause seizures and/or coma but does not typically present with vaginal bleeding. Choices A, C, and D are abnormal conditions that can cause bleeding, particularly in the third trimester. Placenta previa (choice A) is a condition where the placenta partially or completely covers the cervix, leading to vaginal bleeding. Abruptio placentae (choice C) is the premature separation of the placenta from the uterine wall, causing vaginal bleeding. Uterine rupture (choice D) is a serious obstetrical emergency where the uterus tears during pregnancy or childbirth, resulting in severe bleeding.

4. Which of the following lab values is associated with a decreased risk of cardiovascular disease?

• A. high HDL cholesterol
• B. low HDL cholesterol
• C. low total cholesterol
• D. low triglycerides

Correct answer: B

Rationale: High HDL cholesterol is associated with a decreased risk of cardiovascular disease because HDL cholesterol is known as 'good' cholesterol. It helps remove other forms of cholesterol, like LDL cholesterol, from the bloodstream, reducing the risk of plaque buildup in the arteries. Low HDL cholesterol (Choice B) is actually a risk factor for cardiovascular disease because it means there is less of the 'good' cholesterol to perform its protective functions. Low total cholesterol (Choice C) and low triglycerides (Choice D) are not necessarily associated with a decreased risk of cardiovascular disease, as the balance and types of cholesterol play a more crucial role in heart health.

5. A licensed practical nurse tells the certified nursing assistant (CNA) staff that they will need to comply with the mandatory overtime policy that the long-term care facility has implemented. Later that day, the nurse overhears a CNA complaining about the policy and telling other CNAs that she will not work the overtime if she has made other plans after her regular shift. What is the best approach for the nurse to use in dealing with the conflict?

• A. Providing a positive reward system for the CNA to encourage working the mandatory overtime
• B. Ignoring the complaints
• C. Avoiding assigning the CNA mandatory overtime
• D. Meeting with the CNA regarding her behavior concerning the overtime policy

Correct answer: D

Rationale: In this situation, the best approach for the nurse is to meet with the CNA regarding her behavior concerning the overtime policy. Initiating a discussion is crucial to address resistance by a staff member. A face-to-face meeting allows for the verbalization of feelings, identification of problems, and the opportunity to develop strategies to solve the issue. Ignoring the complaints and avoiding assigning mandatory overtime do not tackle the root of the problem. Providing a positive reward system might offer a temporary fix but does not directly address the resistance and conflict.

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