Nursing Elites

1. While caring for a client receiving morphine, what assessment is the priority for a nurse to conduct?

• A. Blood pressure
• B. Heart rate
• C. Respiratory rate
• D. Temperature

Correct answer: C

Rationale: The correct answer is monitoring the respiratory rate. Morphine can depress respiratory function, leading to respiratory depression or arrest. Therefore, closely monitoring the client's respiratory rate is crucial to detect any signs of respiratory distress. While blood pressure, heart rate, and temperature are important assessments, in this scenario, respiratory rate takes precedence due to the potential respiratory complications associated with morphine administration.

2. A client with severe dyspnea is scheduled for multiple diagnostic tests. Which test should the nurse prioritize?

• A. Administer an echocardiogram first.
• B. Prioritize a chest x-ray for the client.
• C. Prepare the client for a CT scan.
• D. Order an MRI first.

Correct answer: B

Rationale: The correct answer is B: Prioritize a chest x-ray for the client. When a client presents with severe dyspnea, a chest x-ray should be prioritized as it helps in assessing the lungs and heart, which are crucial in cases of respiratory distress. Echocardiograms are more focused on assessing heart function and may not provide immediate information needed in cases of dyspnea. CT scans and MRIs are more detailed imaging studies that are not typically the first-line diagnostic tests for severe dyspnea.

3. A school nurse is providing care for students in an elementary education facility. Which of the following interventions by the nurse addresses the primary level of prevention?

• A. Design interventions for a student's individual education plan (IEP).
• B. Teach students about healthy food choices.
• C. Perform first aid for minor injuries.
• D. Perform scoliosis screenings for students.

Correct answer: B

Rationale: The correct answer is B because teaching students about healthy food choices is a primary prevention strategy that aims to prevent future health issues by promoting healthy behaviors. Choice A, designing interventions for an individual education plan (IEP), is more related to addressing specific educational needs rather than preventing health issues. Choice C, performing first aid for minor injuries, is a form of secondary prevention aimed at reducing the impact of existing health problems. Choice D, performing scoliosis screenings for students, falls under secondary prevention by detecting health issues early rather than preventing them.

4. What is the most important nursing intervention when caring for a patient with a wound?

• A. Apply an occlusive dressing over the wound.
• B. Clean the wound with normal saline.
• C. Administer antibiotics as prescribed.
• D. Reassess the wound every 4 hours for changes.

Correct answer: B

Rationale: The most important nursing intervention when caring for a patient with a wound is to clean the wound with normal saline. This is crucial for preventing infection and promoting healing. Applying an occlusive dressing (Choice A) can be important but should come after cleaning the wound. Administering antibiotics (Choice C) is not the first-line intervention for all wounds and should be based on the healthcare provider's prescription. Reassessing the wound (Choice D) is essential but not the most important initial intervention.

5. A healthcare professional is teaching a patient how to prevent falls at home. Which instruction is most appropriate?

• A. Keep your living space well-lit.
• B. Remove loose rugs and install grab bars in the bathroom.
• C. Use furniture to provide support when walking.
• D. Wear socks without shoes to prevent slipping.

Correct answer: B

Rationale: The most appropriate instruction to prevent falls at home is to remove loose rugs and install grab bars in high-risk areas like the bathroom. This helps eliminate tripping hazards and provides stability for the patient. Keeping the living space well-lit (Choice A) is important but may not directly address fall prevention. Using furniture for support (Choice C) can lead to accidents if the furniture is not stable. Wearing socks without shoes (Choice D) increases the risk of slipping rather than preventing falls.

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