Nursing Elites

1. A newly admitted adult client has a diagnosis of hepatitis A. The charge nurse should reinforce to the staff members that the most significant routine infection control strategy, in addition to hand washing, to be implemented is which of these?

• A. Apply appropriate signs outside and inside the room
• B. Apply a mask with a shield if there is a risk of fluid splash
• C. Wear a gown to change soiled linens from incontinence
• D. Have gloves on while handling bedpans with feces

Correct answer: D

Rationale: The correct answer is to have gloves on while handling bedpans with feces. Hepatitis A is transmitted through the fecal-oral route, and using gloves during such direct contact with feces is crucial in preventing the transmission of the infection. Choice A is not directly related to infection control for hepatitis A. Choice B is more relevant to preventing droplet transmission rather than fecal-oral transmission. Choice C is important for preventing contact transmission from soiled linens but is not as directly related to the mode of transmission of hepatitis A as using gloves when handling feces.

2. The client is receiving discharge teaching for heart failure. Which statement made by the client indicates a need for further teaching?

• A. I will weigh myself daily and report any significant weight gain to my healthcare provider.
• B. I will limit my sodium intake to help manage my heart failure.
• C. I will take my medications as prescribed by my healthcare provider.
• D. I will stop taking my medications if I feel better.

Correct answer: D

Rationale: Choice D is the correct answer because stopping medications when feeling better can be harmful in heart failure. It is essential to complete the full course of medication as prescribed by the healthcare provider to effectively manage heart failure. Choices A, B, and C demonstrate good understanding and compliance with heart failure management strategies, such as monitoring weight, restricting sodium intake, and adhering to prescribed medications, respectively.

3. The nurse is about to assess a 6-month-old child with nonorganic failure-to-thrive (NOFTT). Upon entering the room, the nurse would expect the baby to be

• A. Irritable and 'colicky' with no attempts to pull to standing
• B. Alert, laughing, and playing with a rattle, sitting with support
• C. Skin color dusky with poor skin turgor over the abdomen
• D. Pale, thin arms and legs, uninterested in surroundings

Correct answer: D

Rationale: A baby with nonorganic failure-to-thrive often appears pale, thin, and uninterested in their surroundings. Choice A is incorrect as 'irritable and colicky with no attempts to pull to standing' is more indicative of other conditions like colic. Choice B is incorrect as a baby with nonorganic failure-to-thrive is unlikely to be alert, laughing, and playing, as they would typically present with signs of failure to thrive. Choice C is incorrect as dusky skin color and poor skin turgor are not typical findings in a baby with nonorganic failure-to-thrive.

4. A nurse at a provider's office is reinforcing teaching with a client who is being treated with chemotherapy and is losing weight. Which of the following instructions should the nurse give to increase the client's caloric intake? (Select one that doesn't apply).

• A. Top yogurt with granola.
• B. Use honey on toast.
• C. Use milk instead of water in recipes.
• D. Increase fluids during meals.

Correct answer: D

Rationale: Increasing fluids during meals does not directly contribute to increasing caloric intake. Topping yogurt with granola, using honey on toast, and using milk instead of water in recipes are effective ways to boost caloric intake. While adequate fluid intake is important for hydration and overall health, it does not address the specific need to increase caloric intake in this scenario.

5. A nurse is reinforcing teaching about reliable sources of Vitamin B12 with a client who is pregnant. Which of the following foods should the nurse recommend in the teaching?

• A. Figs
• B. Broccoli
• C. Stewed tomatoes
• D. Skim milk

Correct answer: D

Rationale: Skim milk is a reliable source of Vitamin B12, which is essential for the health of both the mother and the developing fetus. While figs, broccoli, and stewed tomatoes are nutritious foods, they are not significant sources of Vitamin B12. Figs are a good source of fiber and other vitamins, broccoli is rich in Vitamin C and K, and stewed tomatoes are high in Vitamin C and antioxidants, but they do not contain Vitamin B12 as much as skim milk does.

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