Nursing Elites

1. A healthcare professional is supervising a newly licensed colleague who is preparing to administer an intramuscular injection. Which of the following actions by the newly licensed colleague requires intervention?

• A. Selecting a 25-gauge needle
• B. Administering the injection at a 45° angle
• C. Using the ventrogluteal site for the injection
• D. Aspirating for blood return before injecting the medication

Correct answer: B

Rationale: The correct answer is B. Administering an intramuscular injection at a 90° angle is essential for proper medication delivery into the muscle tissue. Injecting at a 45° angle is incorrect for intramuscular injections and is typically used for subcutaneous injections where the needle is inserted into the fatty tissue layer beneath the skin. Choice A is correct as selecting a 25-gauge needle is appropriate for an intramuscular injection. Choice C is also correct as the ventrogluteal site is a suitable site for intramuscular injections. Choice D is correct as aspirating for blood return is a necessary step to ensure the needle is not in a blood vessel before injecting the medication.

2. When assisting a client with bilateral casts on her hands with feeding, what action should the nurse take?

• A. Sit at the bedside when feeding the client
• B. Provide pureed foods
• C. Ensure feedings are provided at room temperature
• D. Offer the client a drink of fluid after every bite

Correct answer: A

Rationale: When assisting a client with bilateral casts on her hands with feeding, the nurse should sit at the bedside. This action is crucial to provide the client with the nurse's full attention during the feeding process. Sitting at the bedside helps avoid appearing rushed and ensures a safe and comfortable environment for the client. Choices B, C, and D are incorrect because while they may be relevant in other situations, the priority when assisting a client with bilateral casts on her hands is to ensure proper attention and a comfortable setting during feeding.

3. A client with celiac disease is being taught about dietary management. Which statement by the client indicates an understanding of the teaching?

• A. I should avoid foods that contain gluten.
• B. I should increase my intake of foods high in gluten.
• C. I should avoid foods that contain lactose.
• D. I should increase my intake of foods high in lactose.

Correct answer: A

Rationale: The correct answer is A: 'I should avoid foods that contain gluten.' Celiac disease requires the avoidance of gluten-containing foods to manage symptoms and prevent complications. Gluten is found in wheat, barley, and rye. Choices B, C, and D are incorrect as they do not align with the dietary requirements for managing celiac disease. Increasing intake of foods high in gluten or lactose would be detrimental for someone with celiac disease.

4. A client has a prescription for a 24-hour urine collection. Which of the following actions should be taken by the healthcare provider?

• A. Discard the first voiding.
• B. Keep the urine at room temperature.
• C. Collect the first voiding.
• D. Keep the urine in a sterile container.

Correct answer: A

Rationale: Discarding the first voiding is necessary when initiating a 24-hour urine collection to ensure that the collection starts with an empty bladder. This step helps in obtaining an accurate measurement of substances excreted over the 24-hour period without any carryover from the previous voids. Keeping the urine at room temperature or in a sterile container is not specific to the initiation of the collection. Therefore, the correct action is to discard the first voiding. Choice B is incorrect because keeping urine at room temperature is important for some tests, but it is not specific to the initiation of a 24-hour urine collection. Choice C is incorrect because collecting the first voiding would lead to inaccurate results as the bladder is not empty at the start. Choice D is incorrect because while keeping urine in a sterile container is generally a good practice, it is not a specific step for initiating a 24-hour urine collection.

5. A healthcare professional is planning care for a client who has a new prescription for a low-sodium diet. Which of the following foods should the healthcare professional recommend?

• A. Canned soup
• B. Fresh fruit
• C. Pickles
• D. Soy sauce

Correct answer: B

Rationale: Fresh fruit is naturally low in sodium and is a suitable choice for a low-sodium diet. It provides essential nutrients without adding significant amounts of sodium, making it a healthy option for individuals following a low-sodium diet. Canned soup, pickles, and soy sauce are high in sodium content and should be avoided by individuals on a low-sodium diet. Canned soups are often loaded with added salt, pickles are preserved in brine containing high sodium levels, and soy sauce is a condiment with a high sodium content.

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