Nursing Elites

1. A client arrives speaking only Spanish. What is the priority nursing intervention?

• A. Give the client a tour of the unit
• B. Verify the reason for admission
• C. Request a medical interpreter
• D. Call the chaplain for support

Correct answer: C

Rationale:

2. A client just received a diagnosis of cancer. Which statement by the nurse demonstrates empathy?

• A. "This must be hard news to hear. Tell me more about it."?
• B. "I believe you can overcome this because I have seen how strong you are."?
• C. "Tomorrow will be better."
• D. "What is your biggest fear about this diagnosis?"?

Correct answer: A

Rationale:

3. What intervention by the nurse would be the best to prevent deep vein thrombosis after a fracture of the hip?

• A. Encouraging bedrest
• B. Applying antiembolism stockings
• C. Tell the client to take anticoagulants
• D. Teaching about smoking cessation

Correct answer: B

Rationale: The best intervention to prevent deep vein thrombosis (DVT) after a fracture of the hip is to apply antiembolism stockings. These stockings help promote circulation and prevent blood clots from forming in the legs due to immobility. Encouraging bedrest is not recommended as it can increase the risk of DVT. While anticoagulants are used in some cases, the primary prevention method is mechanical prophylaxis like antiembolism stockings. Teaching about smoking cessation is important for overall health but is not directly related to preventing DVT in this scenario.

4. The following client come to the ophthalmology clinic. Which client needs to be seen first?

• A. Client who had recent cataract surgery and has worsening vision
• B. Client with an absent red reflex on ophthalmic examination
• C. Client with an intraocular pressure of 24 mm Hg
• D. Client with a tearing, reddened eye with exudate

Correct answer: A

Rationale: Worsening vision after cataract surgery requires immediate attention to prevent complications.

5. What is the priority nursing diagnosis after surgery to repair a fracture?

• A. Disturbed body image
• B. Risk for infection
• C. Risk for impaired skin integrity
• D. Acute pain

Correct answer: B

Rationale: The correct answer is B: Risk for infection. After surgery to repair a fracture, the priority nursing diagnosis is to monitor for the risk of infection to promote proper healing. Infections can significantly delay the healing process and lead to further complications. Choices A, C, and D are not the priority immediately post-surgery. Disturbed body image, risk for impaired skin integrity, and acute pain may be concerns but are not the priority in the immediate post-operative period following fracture repair.

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