Nursing Elites

1. A nurse is assessing a client who has a femur fracture and is in skeletal traction. Which of the following findings should the nurse report to the provider?

• A. Clear fluid drainage from the pin sites
• B. Client reporting intermittent muscle spasms
• C. Client reporting severe pain despite receiving analgesics
• D. The traction weights are hanging freely

Correct answer: C

Rationale: The correct answer is C. Severe pain that is not relieved by analgesics may indicate neurovascular compromise or other complications and requires immediate attention by the provider. Choices A, B, and D are incorrect because clear fluid drainage from the pin sites is expected in skeletal traction, intermittent muscle spasms are common in this situation, and traction weights hanging freely indicate proper traction alignment.

2. A nurse is caring for a client with a sealed radiation implant. Which action should the nurse take?

• A. Remove dirty linens after double-bagging
• B. Wear a dosimeter badge
• C. Limit visitors to 1 hour per day
• D. Ensure family remains 3 feet away from the client

Correct answer: B

Rationale: The correct answer is B: Wear a dosimeter badge. When caring for a client with a sealed radiation implant, the nurse should wear a dosimeter badge to monitor radiation exposure. This badge helps measure the amount of radiation the nurse is exposed to during care. Choice A is incorrect because removing dirty linens after double-bagging is not directly related to managing radiation exposure. Choice C is incorrect as there is no specific time limit on visitors mentioned in the context of a sealed radiation implant. Choice D is incorrect as there is no evidence supporting the need for family members to stay a specific distance away from the client.

3. A nurse manager is teaching a group of employees about QSEN. What statement by an employee should the nurse manager identify as quality improvement?

• A. We should track the rate of hospital-acquired infections.
• B. We should evaluate patient satisfaction scores.
• C. We should start tracking how soon patients are discharged after laparoscopic versus open surgery.
• D. We should check the patient's temperature before discharge.

Correct answer: C

Rationale: The correct answer is C. QSEN focuses on quality improvement in healthcare. Tracking how soon patients are discharged after different types of surgeries helps in evaluating the quality of care provided and identifying areas for improvement. Choices A and B focus on monitoring outcomes but do not directly relate to quality improvement initiatives. Choice D is more about a routine assessment before discharge and does not involve a quality improvement process.

4. A charge nurse on a med-surg unit is preparing to delegate tasks to a licensed practical nurse (LPN). What task should the charge nurse delegate to the LPN?

• A. Initiate a care plan.
• B. Perform a complex wound dressing change.
• C. Administer an oral antibiotic to a patient.
• D. Complete an initial assessment.

Correct answer: C

Rationale: The correct task that the charge nurse should delegate to the LPN is to administer an oral antibiotic to a patient. LPNs are trained and permitted to administer medications orally under the supervision of a registered nurse. Initiating a care plan (Choice A) and completing an initial assessment (Choice D) are tasks that typically require higher-level nursing education and critical thinking skills, which are more suitable for registered nurses. Performing a complex wound dressing change (Choice B) involves specialized skills and assessment that are often within the scope of practice of registered nurses or wound care specialists.

5. A healthcare professional is assessing a client with deep vein thrombosis (DVT). Which of the following interventions should the healthcare professional include in the plan of care?

• A. Apply ice packs to the affected extremity.
• B. Encourage ambulation every hour.
• C. Elevate the affected leg when in bed.
• D. Massage the affected area to improve circulation.

Correct answer: C

Rationale: Elevating the affected leg is a crucial intervention in the care of a client with deep vein thrombosis (DVT). This position helps reduce swelling and promotes venous return, which can alleviate symptoms associated with DVT. Applying ice packs (Choice A) may worsen the condition by causing vasoconstriction. Encouraging ambulation (Choice B) can dislodge the clot and lead to fatal complications. Massaging the affected area (Choice D) can also dislodge the clot and is contraindicated in DVT.

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