Nursing Elites

1. During a work shift, how can a nurse best demonstrate the dynamic nature of the nursing process?

• A. Collaborating with the client to establish healthcare goals
• B. Reviewing the client's medical record history
• C. Explaining the purpose of administered medications to the client
• D. Rapidly resetting priorities for client care based on changes in the client's condition

Correct answer: D

Rationale: The nursing process is dynamic as it involves adapting to the changing health status of the client. Rapidly resetting priorities for client care based on changes in the client's condition exemplifies this dynamic nature by responding promptly to evolving circumstances. Collaborating with the client to establish healthcare goals (Option A), reviewing the client's medical record history (Option B), and explaining the purpose of administered medications to the client (Option C) are all essential nursing actions but do not directly showcase the dynamic nature of the nursing process.

2. For a healthcare worker under normal conditions with unsoiled hands, effective hand hygiene between patients requires which of the following?

• A. At least a 15-second scrub with plain soap and water
• B. At least a 23-minute scrub with an antimicrobial soap
• C. Use of an alcohol-based antiseptic hand-rub
• D. Wearing a mask when scrubbing

Correct answer: C

Rationale: Effective hand hygiene between patients for a healthcare worker with unsoiled hands involves using an alcohol-based antiseptic hand rub. This method is sufficient for cleaning hands that are not visibly soiled. The use of an antimicrobial soap or a prolonged scrubbing time is unnecessary and not recommended in this scenario. Wearing a mask is not required for routine hand hygiene and does not contribute to effective hand cleaning.

3. A patient's urine tests positive for glucose. The doctor asks you to confirm this finding. Which of the following would BEST confirm this finding?

• A. Run the urine on the hand-held glucometer.
• B. Have another MA perform a repeat dipstick test.
• C. Run a Clinitest.
• D. Run an Acetest.

Correct answer: C

Rationale: To confirm glucosuria, the most appropriate method is to run a Clinitest. Clinitest tablets are specifically designed to detect glucose in urine samples. This test is particularly useful when the urine is discolored, making it challenging to accurately assess the color change.\n Choice A, using a hand-held glucometer, is not the standard method for confirming glucose in urine; these devices are primarily used for blood glucose monitoring.\n Choice B, having another Medical Assistant perform a repeat dipstick test, may not provide a more definitive confirmation as dipstick tests can sometimes yield false positives or be less accurate compared to other methods like the Clinitest.\n Choice D, running an Acetest, is used to detect ketones in the urine, not glucose. Ketones are typically associated with conditions like diabetic ketoacidosis, which is different from glucosuria.

4. A physician has ordered that a client must be placed in a high Fowler's position. How does the nurse position this client?

• A. The client is placed face-down
• B. The client lies on his back with his head lower than his feet
• C. The client lies on his back with the knees drawn up toward the chest
• D. The client is sitting with the backrest at a 90-degree angle

Correct answer: D

Rationale: A high Fowler's position is a modification of the semi-Fowler's position, in which the client is seated with arms resting at the sides or in the lap. The high Fowler's position requires that the client's head and upper chest are elevated, and the backrest is at a 90-degree angle. This position supports breathing and appropriate chest wall movement, making it easier for the client to breathe. Choices A, B, and C are incorrect because a high Fowler's position involves the client being in a sitting position with the backrest at a 90-degree angle, not being face-down, lying with the head lower than the feet, or lying on the back with knees drawn up towards the chest.

5. What procedure examines a portion of the large intestine with an endoscope?

• A. Colposcopy
• B. Sigmoidoscopy
• C. Upper GI
• D. Cardiac catheterization

Correct answer: B

Rationale: Sigmoidoscopy is the correct answer because it specifically examines the sigmoid colon located in the descending colon using an endoscope inserted through the rectum. This procedure captures video and images of the large intestine's lining, helping in the diagnosis of conditions like inflammatory bowel disease or colorectal cancer. Colposcopy, on the other hand, is a procedure for examining the cervix and vagina, not the large intestine. Upper GI involves capturing images of the esophagus and stomach, focusing on the upper gastrointestinal tract, not the large intestine. Cardiac catheterization is a procedure that involves threading a thin instrument through the femoral artery to the heart, used for cardiac interventions and not related to examining the large intestine.

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