Nursing Elites

1. A client is being prepared for placement of a catheter for total parenteral nutrition. Which of the following access sites should be planned for catheter insertion?

• A. Left antecubital vein
• B. Right subclavian vein
• C. Right femoral artery
• D. Left arm radial artery

Correct answer: B

Rationale: The correct answer is the Right subclavian vein. When preparing a client for placement of a catheter for total parenteral nutrition, the preferred access site for catheter insertion is the subclavian vein due to its large size, central location, and lower risk of infection compared to peripheral veins. The other options provided (Left antecubital vein, Right femoral artery, and Left arm radial artery) are not suitable access sites for central venous catheter insertion for total parenteral nutrition.

2. One of the following statements is true with regards to the care of clients with depression:

• A. Only mentally ill persons commit suicide
• B. All depressed clients are considered potentially suicidal
• C. Most suicidal person gives no warning
• D. The chance of suicide lessens as depression lessens

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

3. What is a likely effect on a patient whose lab results reveal hypoalbuminemia?

• A. Infection
• B. Rickets
• C. Hypertension
• D. Edema

Correct answer: D

Rationale: Hypoalbuminemia, which refers to low albumin levels in the blood, is often associated with edema. Albumin helps maintain oncotic pressure, which keeps fluid within blood vessels. When albumin levels are low, this pressure decreases, leading to fluid leakage from the blood vessels into the surrounding tissues, resulting in edema. The other choices are less likely effects of hypoalbuminemia. Hypoalbuminemia doesn't directly cause infections (Choice A), rickets (Choice B) caused by vitamin D deficiency, or hypertension (Choice C) associated with factors like high sodium intake, obesity, and genetic predisposition.

4. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. What will you do first?

• A. Write an incident report and refer the matter to the nursing director
• B. Keep your findings to yourself
• C. Report the matter to your supervisor
• D. Find out from the endorsement any patient who might have been given narcotics

Correct answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

5. If a child has two or more pink signs, you would classify the child as having:

• A. No disease
• B. Mild form of disease
• C. Urgent Referral
• D. Very severe disease

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

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