Nursing Elites

1. During a mass casualty event, a nurse is caring for multiple clients. Which of the following clients is the nurse’s priority?

• A. A client who received crush injuries to the chest and abdomen and is expected to die.
• B. A client who has a 4-inch laceration to the head.
• C. A client who has partial-thickness and full-thickness burns to his face, neck, and chest.
• D. A client who has a fractured fibula and tibia.

Correct answer: C

Rationale: During a mass casualty event, the priority client for the nurse is the one with partial-thickness and full-thickness burns to the face, neck, and chest. Clients with severe burns in critical areas require immediate attention due to the potential for life-threatening complications such as airway compromise, fluid loss, and infection. Crush injuries and fractures, although serious, are generally less urgent in comparison and can be managed after addressing the burns. Therefore, the client with burns to the face, neck, and chest should be the nurse's priority over the other clients described.

2. During an admission assessment for an older adult client, what is the priority action for the nurse after gathering data and reviewing systems?

• A. Orient the client to their room.
• B. Conduct a client care conference.
• C. Review medical prescriptions.
• D. Develop a plan of care.

Correct answer: A

Rationale: The priority action for the nurse after completing the assessment and review of systems for an older adult client is to orient them to their room. This is crucial for ensuring the client's comfort and safety in the new environment. While reviewing medical prescriptions and developing a plan of care are important aspects of the admission process, they can be done after the client has been oriented to their room.

3. The healthcare provider is providing postoperative care to a client who had a submucosal resection (SMR) for a deviated septum. The healthcare provider should monitor for what complication associated with this type of surgery?

• A. Occipital headache
• B. Periorbital crepitus
• C. Expectoration of blood
• D. Changes in vocalization

Correct answer: C

Rationale: Expectoration of blood is a potential complication following SMR surgery, as it may indicate bleeding postoperatively. In contrast, occipital headache (choice A) is not a common complication associated with SMR surgery. Periorbital crepitus (choice B) is more related to facial fractures or certain infections rather than SMR surgery. Changes in vocalization (choice D) are not typically associated with complications following SMR surgery.

4. The healthcare provider is caring for a patient with a spinal cord injury and notices that the patient's hips have a tendency to rotate externally when the patient is supine. Which device will the healthcare provider use to help prevent injury secondary to this rotation?

• A. Hand rolls
• B. A trapeze bar
• C. A trochanter roll
• D. Hand-wrist splints

Correct answer: C

Rationale: A trochanter roll is the correct choice as it is used to prevent external rotation of the hips when the patient is in a supine position. Hand rolls (Choice A) are incorrect because they are used to prevent contractures of the fingers, wrist, and hand. A trapeze bar (Choice B) is not the correct option as it helps patients change positions in bed and aids with movement, not specifically for hip rotation. Hand-wrist splints (Choice D) are also incorrect as they are used to maintain the functional position of the wrist and hand, not to address hip rotation.

5. A charge nurse is assigning client care for four clients. Which of the following tasks should the nurse assign to a PN?

• A. Creating a plan of care for a client who is recovering following a stroke.
• B. Assessing a pressure injury on a client who is on bed rest.
• C. Providing nasopharyngeal suctioning for a client who has pneumonia.
• D. Teaching a client who has asthma to use a metered-dose inhaler.

Correct answer: C

Rationale: The correct answer is providing nasopharyngeal suctioning for a client who has pneumonia. This task falls within the practical nurse's scope of practice, as it involves direct patient care and basic interventions. Creating a plan of care for a client recovering from a stroke involves critical thinking and comprehensive assessment, which are typically responsibilities of registered nurses. Assessing a pressure injury requires specialized wound care knowledge, often performed by wound care specialists or registered nurses with wound care training. Teaching a client to use a metered-dose inhaler involves patient education and requires a thorough understanding of asthma management, making it more suitable for a registered nurse.

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