Nursing Elites

1. A nurse is teaching about foot care to a client who has diabetes mellitus (DM). What statement indicates understanding?

• A. I should wear my slippers whenever I am out of bed
• B. I can walk barefoot at home
• C. I should apply lotion between my toes
• D. I can soak my feet in warm water

Correct answer: A

Rationale: The correct answer is A. Wearing slippers or shoes when out of bed is crucial for clients with diabetes as it protects the feet from injury. Walking barefoot, as mentioned in option B, can increase the risk of cuts, sores, and infections in diabetic patients. Applying lotion between the toes, as stated in option C, can lead to maceration and increase the risk of fungal infections. Similarly, soaking feet in warm water, as mentioned in option D, can cause skin breakdown and should be avoided by diabetic patients.

2. A charge nurse on a med-surg unit is preparing to delegate tasks to a licensed practical nurse (LPN). What task should the charge nurse delegate to the LPN?

• A. Initiate a care plan.
• B. Perform a complex wound dressing change.
• C. Administer an oral antibiotic to a patient.
• D. Complete an initial assessment.

Correct answer: C

Rationale: The correct task that the charge nurse should delegate to the LPN is to administer an oral antibiotic to a patient. LPNs are trained and permitted to administer medications orally under the supervision of a registered nurse. Initiating a care plan (Choice A) and completing an initial assessment (Choice D) are tasks that typically require higher-level nursing education and critical thinking skills, which are more suitable for registered nurses. Performing a complex wound dressing change (Choice B) involves specialized skills and assessment that are often within the scope of practice of registered nurses or wound care specialists.

3. A nurse is caring for a client with deep vein thrombosis (DVT). Which of the following interventions should the nurse include in the plan of care?

• A. Position the client with the affected leg below the heart
• B. Massage the affected extremity every 4 hours
• C. Apply cold compresses to the affected extremity
• D. Elevate the affected leg while in bed

Correct answer: D

Rationale: The correct answer is to elevate the affected leg while in bed. Elevating the leg helps reduce swelling and promotes venous return, aiding in the management of DVT. Positioning the affected leg below the heart can worsen the condition by increasing the risk of clot dislodgment. Massaging the affected extremity can also dislodge the clot and should be avoided. Cold compresses are not recommended as they can cause vasoconstriction, potentially worsening the condition.

4. A nurse is assessing a client for signs of anemia. Which of the following findings should the nurse look for?

• A. Increased energy
• B. Pale skin
• C. Elevated blood pressure
• D. Weight gain

Correct answer: B

Rationale: The correct answer is B: 'Pale skin.' Pale skin is a common sign of anemia due to reduced hemoglobin levels, which affects the skin color. Anemia is characterized by a decrease in the number of red blood cells or hemoglobin in the blood, leading to a paler complexion. Choices A, C, and D are incorrect. 'Increased energy' is not typically associated with anemia, as fatigue is a common symptom. 'Elevated blood pressure' is not a typical finding in anemia; instead, anemia may cause hypotension. 'Weight gain' is not a direct symptom of anemia; in fact, weight loss may occur in some cases due to reduced appetite or other factors associated with anemia.

5. While receiving a change of shift report on a group of clients, which patient should the nurse assess first?

• A. The client who has a fractured femur and reports sharp chest pain.
• B. The client who has a fever and is receiving antibiotics.
• C. The client who has a urinary tract infection and reports pain with urination.
• D. The client who is scheduled for surgery in the afternoon.

Correct answer: A

Rationale: The nurse should assess the client with a fractured femur and sharp chest pain first. Sharp chest pain in this client may indicate a pulmonary embolism, a life-threatening condition requiring immediate attention. The other options describe important patient conditions but do not pose an immediate threat to life like a potential pulmonary embolism does.

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