Nursing Elites

1. A nurse is preparing to administer a tuberculosis (TB) test to a client. Which of the following is the correct method for administering this test?

• A. Intradermal injection on the forearm
• B. Subcutaneous injection on the upper arm
• C. Intramuscular injection on the deltoid
• D. Oral administration

Correct answer: A

Rationale: The correct method for administering a tuberculosis (TB) test is through an intradermal injection on the forearm. This technique allows for the proper administration of the test under the skin to assess the body's response to the TB antigen. Choices B, C, and D are incorrect because the TB test specifically requires an intradermal injection, not subcutaneous, intramuscular, or oral administration.

2. The RN is serving on a medical center committee to update goals and protocols based on the national standards. Which goal most directly addresses the Healthy People 2020 initiative?

• A. Reduce ED wait time for indigent clients
• B. Providing transportation for medically challenged clients
• C. Provide access to health services
• D. Refer clients to local health department for medical services

Correct answer: C

Rationale: The correct answer is C: 'Provide access to health services.' This goal most directly addresses the Healthy People 2020 initiative, which aims to improve health care access for all individuals. Option A, 'Reduce ED wait time for indigent clients,' focuses on efficiency rather than access. Option B, 'Providing transportation for medically challenged clients,' addresses a specific need but does not cover overall health service access. Option D, 'Refer clients to local health department for medical services,' involves referral rather than direct access to services.

3. The nurse is working in a community health clinic that serves a diverse population. Which of the following actions best demonstrates cultural competence?

• A. Learning about the cultural practices of the clinic's client population
• B. Providing translation services for non-English speaking clients
• C. Treating all clients the same regardless of their background
• D. Encouraging clients to adopt mainstream health practices

Correct answer: A

Rationale: Learning about the cultural practices of the clinic's client population is the best way to demonstrate cultural competence. This action shows respect for the diverse backgrounds of the clients and helps in providing care that is sensitive to their cultural beliefs and practices. Providing translation services (Choice B) is important for effective communication but may not address the deeper aspects of cultural competence. Treating all clients the same (Choice C) may overlook the unique needs that arise from cultural differences. Encouraging clients to adopt mainstream health practices (Choice D) may not be appropriate or respectful of their cultural traditions and preferences.

4. The nurse is teaching childbirth preparation classes. One woman asks about her rights to develop a birthing plan. Which response made by the nurse would be best?

• A. "What is your reason for wanting such a plan?"
• B. "Have you talked with your health care provider about this?"
• C. "Let us discuss your rights as a couple."
• D. "Write your ideal plan for the next class."

Correct answer: C

Rationale: Discussing the rights as a couple allows for open communication and helps ensure that the birthing plan aligns with the couple's preferences and medical advice.

5. Which of the following patients should the home care nurse assess first?

• A. A 65-year-old male with known COPD and difficulty breathing after climbing a flight of stairs.
• B. A 78-year-old with CHF who has gained 4 lbs according to her tele-monitoring.
• C. A 50-year-old with bilateral leg swelling and difficulty walking.
• D. A 60-year-old with lower back pain.

Correct answer: A

Rationale: The correct answer is A. A patient with known COPD and difficulty breathing after physical exertion like climbing stairs requires immediate assessment by the nurse. This could indicate a potential exacerbation of COPD, which needs prompt intervention to prevent respiratory distress. Choices B, C, and D describe important patient situations that also require attention, but the urgency is higher with a COPD patient experiencing difficulty breathing.

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