Nursing Elites

1. During physical therapy, a client with Parkinson's disease makes the following statements. Which statement indicates the need for a referral to physical therapy?

• A. ''I have been experiencing more tremors in my left arm than before''
• B. ''I noticed that I am having a harder time holding on to my toothbrush''
• C. ''Lately, I feel like my feet are freezing up, as they are stuck to the ground''
• D. ''Sometimes, I feel I am making a chewing motion when I'm not eating''

Correct answer: C

Rationale: Feeling like the feet are freezing up and sticking to the ground is a common symptom of Parkinson's disease known as 'freezing of gait.' This symptom significantly impacts mobility and can be dangerous, indicating the need for specialized physical therapy interventions to address gait disturbances and improve mobility.

2. What is the best position for examining the rectum?

• A. Prone
• B. Sim's
• C. Knee-chest
• D. Lithotomy

Correct answer: C

Rationale: The knee-chest position is the most optimal position for examining the rectum. In this position, the patient kneels on the examination table with their chest resting on it, creating a straight line from the head to the lower back. This position allows for easier access and visualization of the rectal area, making it the preferred choice for rectal examinations. Prone position (choice A) is lying face down and is not ideal for rectal exams as it does not provide good access. Sim's position (choice B) is lying on the left side with the right knee and thigh flexed, also not ideal for rectal exams. Lithotomy position (choice D) is lying on the back with legs flexed and feet in stirrups, primarily used for gynecological exams and surgery, not for rectal examinations.

3. What is a nurse's role in health promotion?

• A. Conducting health risk appraisals
• B. Educating clients to be effective health consumers
• C. Implementing worksite wellness programs
• D. None of the above

Correct answer: B

Rationale: A nurse plays a crucial role in health promotion by educating clients to be effective health consumers. This involves empowering individuals to make informed decisions about their health, access appropriate healthcare services, and engage in healthy behaviors to prevent illness and promote well-being. The other choices are not entirely accurate in describing the primary role of a nurse in health promotion. While nurses may conduct health risk appraisals and implement worksite wellness programs as part of their responsibilities, their central focus is on educating and empowering individuals to take control of their health.

4. Which instrument is used for auscultation?

• A. Percussion hammer
• B. Audiometer
• C. Stethoscope
• D. Sphygmomanometer

Correct answer: C

Rationale: Auscultation involves listening to internal sounds in the body, such as heart and lung sounds. The instrument used for auscultation is a stethoscope, which allows healthcare providers to listen to these sounds. The percussion hammer is used to elicit sounds on the body, the audiometer is used to measure hearing ability, and the sphygmomanometer is used to measure blood pressure. Therefore, the correct answer is 'Stethoscope.'

5. Which of the following principles of primary nursing has proven most satisfying to the patient and nurse?

• A. Continuity of patient care promotes efficient and cost-effective nursing care.
• B. Autonomy and authority for planning are best delegated to a nurse who knows the patient well.
• C. Accountability is clearest when one nurse is responsible for the overall plan and its implementation.
• D. The holistic approach provides for a therapeutic relationship, continuity, and efficient nursing care.

Correct answer: D

Rationale: The holistic approach, encompassing a therapeutic relationship, continuity, and efficient nursing care, is the most satisfying principle of primary nursing. This approach considers the patient as a whole, taking into account physical, emotional, social, and spiritual aspects, which enhances the nurse-patient relationship and promotes comprehensive care. It emphasizes individualized care delivery, continuity of care, and an integrated approach, leading to improved patient satisfaction and nurse fulfillment.

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