Nursing Elites

1. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse make before delegating care?

• A. Is the client's family present so the AP can show them how to turn the client?
• B. Has data been collected about specific client needs related to turning?
• C. Does the AP have time to change the client's central IV line dressing after turning her?
• D. Has the AP checked the client's pain level prior to turning her?

Correct answer: B

Rationale: Before delegating the task of bathing and turning a client with end-stage cancer to an experienced assistive personnel (AP), the nurse must assess specific client needs related to turning. This assessment ensures that the delegated care is tailored to the client's individual requirements, promoting safe and effective care. Option A is incorrect because the presence of the client's family is not directly related to assessing the client's specific needs for turning. Option C is incorrect as it refers to a different task (changing the central IV line dressing) and is not directly related to the turning assessment. Option D is incorrect as checking the client's pain level, although important, is not directly related to the specific needs related to turning the client.

2. What is a major concern about the health-care system in the United States?

• A. Emphasis on disease prevention
• B. Quality of care
• C. Collaborative care
• D. Reduction in hospital-acquired drug-resistant infections

Correct answer: B

Rationale: The major concern about the health-care system in the United States is the quality of care provided. While disease prevention and collaborative care are important aspects, the primary focus of concern is ensuring that the care delivered meets high standards in terms of effectiveness, safety, and patient outcomes. Reduction in hospital-acquired drug-resistant infections, although relevant, is not the primary concern when evaluating the overall quality of healthcare services.

3. Most water leaves the body by way of the:

• A. Lungs
• B. Intestines
• C. Skin
• D. Kidneys

Correct answer: D

Rationale: Most water leaves the body through the kidneys. The kidneys play a crucial role in filtering waste and excess substances from the blood to form urine, which is then excreted out of the body. Choices A, B, and C are incorrect because while a small amount of water can be lost through respiration, feces, and sweating, the primary organ responsible for regulating water balance and excretion is the kidneys.

4. A nurse in a prenatal clinic is caring for a group of clients. Which of the following clients should the nurse recommend for further evaluation and possible intervention?

• A. A client who is at 28 weeks gestation and has a negative Coombs titer
• B. A client who is 39 weeks of gestation and has a negative contraction stress test
• C. A client who is at 35 weeks of gestation and has a biophysical profile of 6
• D. A client who is at 37 weeks of gestation and has an L/S ratio of 2:1

Correct answer: C

Rationale: A biophysical profile of 6 at 35 weeks of gestation indicates a need for further evaluation and possible intervention. A negative Coombs titer at 28 weeks gestation (Choice A) is within normal limits. A negative contraction stress test at 39 weeks gestation (Choice B) is expected as the pregnancy nears term. An L/S ratio of 2:1 at 37 weeks of gestation (Choice D) is consistent with fetal lung maturity.

5. Which of the following is the best way for a nurse to improve quality of care?

• A. Recognize that physicians are among the health-care professionals interested in improving quality of care.
• B. Work with patients and families to improve healthcare.
• C. Collaborate with other health-care professionals, patients, and their families.
• D. Recognize that physicians are among the numerous professionals in health care.

Correct answer: C

Rationale: The best way for a nurse to improve the quality of care is by collaborating with other health-care professionals, patients, and their families. By working together with the healthcare team, patients, and families, nurses can ensure a holistic approach to care delivery, leading to better outcomes. Choices A and D are incorrect as they focus solely on physicians, while choice B, though important, does not fully encompass the collaborative aspect necessary for comprehensive care.

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