Nursing Elites

1. A healthcare professional is preparing to admit a client suspected of having pulmonary tuberculosis. Which of the following actions should the healthcare professional plan to perform first?

• A. Implement airborne precautions.
• B. Obtain a sputum culture.
• C. Administer antituberculosis medications.
• D. Recommend a screening test for close contacts.

Correct answer: A

Rationale: The initial priority when admitting a client suspected of having pulmonary tuberculosis is to implement airborne precautions to prevent the spread of the disease. Airborne precautions include wearing a mask and placing the client in a negative pressure room. Obtaining a sputum culture is essential for confirming the diagnosis, but ensuring infection control measures come first to protect others. Administering antituberculosis medications is important but should be initiated after implementing necessary precautions. Recommending a screening test for close contacts is relevant but is a secondary concern compared to immediate infection control measures.

2. A client is crying while reading from a religious book and asks to be left alone. Which of the following actions should the nurse take?

• A. Contact the hospital’s spiritual services.
• B. Ask what is making the client cry.
• C. Ensure no visitors or staff enter the room for a short time period.
• D. Turn on the television for a distraction.

Correct answer: C

Rationale: The correct action for the nurse to take in this situation is to ensure no visitors or staff enter the room for a short time period. Respecting the client's wish for privacy during emotional moments is crucial for providing patient-centered care. Contacting spiritual services or asking about the reason for crying may intrude on the client's privacy and emotional space. Turning on the television for a distraction is not appropriate as it does not address the client's emotional needs or request for privacy.

3. The client has a nasogastric (NG) tube in place for decompression. What action should the LPN/LVN take to maintain patency of the NG tube?

• A. Irrigate the tube with normal saline every shift.
• B. Check the tube placement by auscultation.
• C. Secure the tube to the client's gown.
• D. Flush the tube with 5 mL of sterile water before and after medication administration.

Correct answer: A

Rationale: To maintain patency of the NG tube, it is essential to irrigate the tube with normal saline every shift. This action helps prevent clogging and ensures that the tube remains clear for effective decompression. Checking tube placement by auscultation (Choice B) is important for verifying correct placement but does not directly impact patency. Securing the tube to the client's gown (Choice C) is crucial for safety and comfort but is not directly related to maintaining patency. Flushing the tube with sterile water before and after medication administration (Choice D) is not the recommended method for maintaining patency of an NG tube, as normal saline is the appropriate solution for this purpose.

4. When replacing a client's surgical dressing, what should the nurse do?

• A. Don sterile gloves to remove the old dressing
• B. Wash hands thoroughly before removing the old dressing
• C. Use sterile gloves to remove the old dressing
• D. Apply a new dressing before removing the old one

Correct answer: C

Rationale: When replacing a client's surgical dressing, the nurse should use sterile gloves to remove the old dressing. Sterile technique is essential to prevent introducing infection to the wound. Choice A is incorrect because clean gloves are not sufficient; sterile gloves are necessary to maintain asepsis. Choice B, washing hands, is an important step before and after the procedure to maintain hand hygiene, but sterile gloves are required during the dressing change. Choice D is incorrect because a new dressing should only be applied after the old one has been removed to prevent contamination and ensure proper wound care.

5. A client on a telemetry unit is being cared for by a nurse after a myocardial infarction. The client expresses, 'All this equipment is making me nervous.' Which of the following responses should the nurse make?

• A. 'All of this equipment can be frightening.'
• B. 'The equipment is necessary to monitor your condition.'
• C. 'You should try to ignore the equipment.'
• D. 'Try to relax; the equipment is not harmful.'

Correct answer: A

Rationale: Choice A is the most appropriate response as it acknowledges the client's feelings, showing empathy and understanding. It validates the client's experience, which can help reduce anxiety and build rapport. Choice B provides information but may not address the client's emotional needs. Choice C dismisses the client's concerns and does not offer support. Choice D minimizes the client's feelings and may not effectively address their anxiety.

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