Nursing Elites

1. A nurse is caring for a client who wanders through the halls yelling obscenities at staff, other clients, and visitors. Which of the following actions should the nurse take?

• A. Keep the client in their room with the door closed
• B. Contact a family member to come and sit with the client
• C. Place the client in a wheelchair with a lap tray
• D. Administer a sedative to the client

Correct answer: B

Rationale: When dealing with a client exhibiting disruptive behavior like yelling obscenities, involving a family member can provide emotional support and help in de-escalating the situation. Keeping the client isolated in their room (Choice A) may lead to further agitation. Placing the client in a wheelchair (Choice C) or administering a sedative (Choice D) should not be the first interventions for managing behavioral issues.

2. Which of the following joints normally allows 360-degree circumflexion?

• A. The knee
• B. The shoulder
• C. The elbow
• D. The fingertips

Correct answer: B

Rationale: The correct answer is B: The shoulder. The shoulder joint is a ball-and-socket joint that allows for a wide range of motion, including 360-degree circumflexion. This joint provides flexibility and mobility in various directions. Choice A, the knee joint, primarily allows flexion and extension but does not have a 360-degree circumflexion. Choice C, the elbow joint, is a hinge joint that permits flexion and extension but not circumflexion. Choice D, the fingertips, do not form a specific joint that allows circumflexion; rather, they have joints that enable bending and straightening movements.

3. A nurse manager observes an assistive personnel (AP) incorrectly transferring a client to the bedside commode. Which of the following should the nurse take first?

• A. Refer the AP to the facility procedure manual
• B. Demonstrate the proper client transfer technique for the AP
• C. Instruct the AP to request assistance when unsure about a task
• D. Help the AP assist the client with the transfer

Correct answer: D

Rationale: The correct first action for the nurse is to ensure the safety of the client by immediately intervening to help the AP with the transfer. This hands-on assistance can prevent any potential harm to the client. Referring the AP to the facility procedure manual (Choice A) might take time and delay the necessary immediate action. Demonstrating the proper technique (Choice B) can be done after ensuring the client's safety. Instructing the AP to request assistance (Choice C) is not the most urgent step when a client's safety is at risk.

4. What is a cavity containing pus surrounded by inflamed tissue?

• A. Cellulitis.
• B. An abscess.
• C. Extravasation.
• D. An adhesion.

Correct answer: B

Rationale: An abscess is defined as a cavity containing pus surrounded by inflamed tissue. Cellulitis is a bacterial skin infection causing redness and swelling, not a cavity. Extravasation is the leakage of fluid from a vessel into surrounding tissues, not a cavity. An adhesion is a band of scar-like tissue that binds two parts together, not a cavity containing pus and inflamed tissue.

5. Based on the signs and symptoms of erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems, and skin nodules in your 32-year-old female patient, what disorder would you most likely suspect?

• A. Leukemia
• B. Histoplasmosis
• C. Pneumocystis jiroveci
• D. Rheumatoid arthritis

Correct answer: D

Rationale: The signs and symptoms described point towards rheumatoid arthritis. Erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac issues, and skin nodules are classic manifestations of rheumatic fever, which is a complication of untreated streptococcal infection. This condition can lead to rheumatoid arthritis over time. Choices A, B, and C are incorrect as they do not align with the provided signs and symptoms, and they are not associated with the clinical presentation described.

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