Nursing Elites

1. A client arrives in the emergency room with a possible fractured femur. The nurse should anticipate an order for:

• A. Trendelenburg position
• B. Ice to the entire extremity
• C. Buck's traction
• D. An abduction pillow

Correct answer: C

Rationale: The correct answer is Buck's traction. This intervention is used to realign the fractured femur, reduce spasms, and alleviate pain. Placing the client in the Trendelenburg position is inappropriate for a femur fracture, making answer A incorrect. While ice may be used post-repair, applying it to the entire extremity is unnecessary, so answer B is wrong. An abduction pillow is typically employed following a total hip replacement, not for a fractured femur, rendering answer D incorrect.

2. Which of the following services is not typically part of family consultation?

• A. assisting with vocational rehabilitation
• B. providing information about the client's illness
• C. teaching effective communication
• D. helping families solve problems

Correct answer: A

Rationale: In family consultation, the primary focus is on helping families address their emotions, enhance communication skills, and resolve issues. Assisting with vocational rehabilitation involves a different scope beyond the typical objectives of family consultation. While providing information about the client's illness, teaching effective communication, and aiding families in problem-solving are common in family consultation to promote understanding, healthy dynamics, and conflict resolution.

3. A home health nurse is making preparations for morning visits. Which one of the following clients should the nurse visit first?

• A. A client with brain attack (stroke) receiving tube feedings
• B. A client with congestive heart failure complaining of nighttime dyspnea
• C. A client who had a thoracotomy 6 months ago
• D. A client with Parkinson’s disease

Correct answer: B

Rationale: The correct answer is B. The client with congestive heart failure complaining of nighttime dyspnea should be seen first as airway management is a priority in nursing care. This client's symptoms indicate potential respiratory distress, requiring immediate attention. Choices A, C, and D involve clients who are more stable and do not present with urgent or acute conditions that require immediate intervention. Choice A with a client receiving tube feedings for a stroke may require attention, but the urgency of addressing potential respiratory distress in choice B takes precedence. Choice C, a client who had a thoracotomy 6 months ago, unless presenting with acute distress, does not necessitate immediate attention. Choice D, a client with Parkinson's disease, is usually a chronic condition that does not typically require immediate intervention for the described scenario.

4. The primary organ for drug elimination is the:

• A. skin
• B. lung(s)
• C. kidney(s)
• D. liver

Correct answer: C

Rationale: The correct answer is the kidney(s) because most drugs are excreted in the urine, either as the parent compound or as drug metabolites. The skin is not the primary organ for drug elimination; only a few drugs are excreted in sweat. The lung(s) primarily excrete volatile gases with expiration, not drugs. While the liver metabolizes drugs, it is the kidney(s) that primarily eliminate drugs through urine, especially those with a molecular weight above 300.

5. Which task should not be performed by the licensed practical nurse?

• A. Inserting a Foley catheter
• B. Discontinuing a nasogastric tube
• C. Obtaining a sputum specimen
• D. Initiating a blood transfusion

Correct answer: D

Rationale: A licensed practical nurse should not initiate a blood transfusion. LPNs can assist with transfusions and verify ID numbers but should not be assigned to initiate the procedure. Inserting Foley catheters, discontinuing nasogastric tubes, and obtaining sputum specimens are within the scope of practice for LPNs. Therefore, options A, B, and C are tasks that LPNs can perform, making them incorrect choices.

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