Nursing Elites

1. A client has a fecal impaction. Before digital removal of the mass, which of the following types of enemas should be administered to soften the feces?

• A. Oil retention
• B. Soapsuds
• C. Saline
• D. Hypertonic

Correct answer: A

Rationale: An oil retention enema is the most appropriate choice to soften and lubricate the feces before digital removal. Oil retention enemas help in making the stool easier to remove digitally due to their lubricating properties. Soapsuds, saline, and hypertonic enemas are not specifically designed to soften feces and are used for different purposes. Soapsuds enemas are used for cleansing, saline enemas for bowel evacuation, and hypertonic enemas for bowel distension in preparation for diagnostic procedures.

2. A charge nurse is explaining the various stages of the lifespan to a group of newly licensed nurses. Which of the following examples should the nurse include as a developmental task for middle adulthood?

• A. The client evaluates their behavior after a social interaction.
• B. The client states they are learning to trust others.
• C. The client wishes to find meaningful friendships.
• D. The client expresses concerns about the next generations.

Correct answer: D

Rationale: The correct answer is D because in middle adulthood, individuals often shift their focus towards concerns related to the next generations. They reflect on their roles in guiding and supporting the younger generations. Choice A is incorrect as evaluating behavior after a social interaction is more relevant to self-awareness, which is not a specific developmental task for middle adulthood. Choice B, learning to trust others, is more commonly associated with early adulthood tasks related to forming intimate relationships. Choice C, wishing to find meaningful friendships, is more aligned with tasks associated with young adulthood and social connections.

3. When performing cardiac chest compressions, what is a critical concept that the nurse must understand?

• A. Push hard and deep on the chest
• B. Compress the chest at a rapid rate
• C. Perform compressions with minimal interruptions
• D. Use a two-handed technique for compressions

Correct answer: A

Rationale: The correct answer is to 'Push hard and deep on the chest.' Effective chest compressions during CPR should be forceful and deep enough to adequately circulate blood to vital organs. This helps maintain perfusion and increases the likelihood of a successful outcome. Compressing the chest at a rapid rate (choice B) is important but not as critical as ensuring the compressions are hard and deep. Performing compressions with minimal interruptions (choice C) is also crucial to maintain blood flow. Using a two-handed technique for compressions (choice D) may be helpful but is not as critical as the depth and force of the compressions.

4. While auscultating the anterior chest of a newly admitted patient, what would the nurse expect to hear?

• A. Normal breathing sounds
• B. Wheezing
• C. Crackles
• D. Stridor

Correct answer: A

Rationale: When auscultating the chest, normal breathing sounds are expected in a healthy individual. Wheezing is a high-pitched whistling sound that indicates narrowed airways and is often heard in conditions like asthma. Crackles are fine, crackling sounds heard on inspiration or expiration and are associated with conditions like pneumonia or heart failure. Stridor is a high-pitched, harsh sound heard during inspiration due to upper airway obstruction. Therefore, choices B, C, and D indicate abnormal respiratory findings, while choice A signifies normal breathing sounds.

5. To evaluate a client's understanding of self-administering insulin within the psychomotor domain of learning, what action should the instructor take?

• A. Have the client demonstrate the procedure.
• B. Explain the procedure again.
• C. Ask the client to describe the procedure.
• D. Observe the client watching a video on the procedure.

Correct answer: A

Rationale: Having the client demonstrate the procedure is the most appropriate action to evaluate understanding within the psychomotor domain of learning. This allows the instructor to assess the client's ability to perform the skill, which is a key aspect of this domain. Choice B, explaining the procedure again, focuses on the cognitive domain rather than the psychomotor domain. Choice C, asking the client to describe the procedure, pertains more to the verbal or cognitive domain of learning. Choice D, observing the client watching a video on the procedure, does not directly assess the client's ability to perform the skill in the psychomotor domain.

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