Nursing Elites

1. A client states, 'I can leave the diaphragm in place as long as I want after intercourse.' Which statement indicates to the nurse that the client needs further information on how to use the diaphragm?

• A. 'I need to reapply spermicidal cream with repeated intercourse.'
• B. 'The diaphragm needs to be filled with spermicidal cream before insertion.'
• C. 'I can leave the diaphragm in place as long as I want after intercourse.'
• D. 'The diaphragm can be inserted as long as 6 hours before intercourse.'

Correct answer: C

Rationale: The correct answer is the statement, 'I can leave the diaphragm in place as long as I want after intercourse.' This statement indicates a lack of understanding about the correct use of the diaphragm. The diaphragm must be left in place for at least 6 hours after intercourse to ensure effectiveness and reduce the risk of pregnancy. Leaving the diaphragm in place for an extended period can lead to toxic shock syndrome. Choice A is correct as spermicidal cream needs to be reapplied before each act of intercourse for optimal contraceptive efficacy. Choice B is a correct statement as the diaphragm should be filled with spermicidal cream before insertion to increase its effectiveness. Choice D is also accurate as the diaphragm can be inserted up to 6 hours before intercourse to allow time for proper placement and effectiveness.

2. People-related supervisory tasks include all of the following except:

• A. coaching
• B. encouraging
• C. target setting
• D. rewarding

Correct answer: C

Rationale: People-related supervisory tasks involve direct interaction with individuals performing the work. Coaching, encouraging, rewarding, evaluating, and facilitating are all part of these tasks as they focus on supporting and motivating employees. Target setting, on the other hand, is a task-centered responsibility that involves projecting goals or objectives to be accomplished. It focuses more on setting objectives and goals rather than directly interacting with individuals, making it the exception among the given choices.

3. A test that can correctly identify those who do not have a given disease is:

• A. specific.
• B. sensitive.
• C. negative culture
• D. marginal finding.

Correct answer: A

Rationale: The correct answer is 'specific.' Specificity refers to the ability of a test to correctly identify individuals who do not have a particular disease. In this case, when the client's lab culture report is negative for the suspected infection, a specific test would correctly identify that the client does not have the disease. 'Sensitive' (Choice B) is incorrect as sensitivity refers to the ability of a test to correctly identify individuals who do have the disease. 'Negative culture' (Choice C) is incorrect as it does not describe the test's ability but rather the result itself. 'Marginal finding' (Choice D) is irrelevant to the concept being tested in this question.

4. Which fetal heart monitor pattern can indicate cord compression?

• A. variable decelerations
• B. early decelerations
• C. bradycardia
• D. tachycardia

Correct answer: A

Rationale: Variable decelerations can indicate cord compression as they are caused by umbilical cord compression or prolapse. This pattern shows an abrupt decrease in heart rate with an erratic shape, often resembling a V or W. Early decelerations (choice B) are typically caused by head compression during contractions and are considered benign. Bradycardia (choice C) is a consistent low heart rate below 110 bpm and is not specific to cord compression. Tachycardia (choice D) is an abnormally high heart rate above 160 bpm and is not associated with cord compression.

5. A licensed practical nurse arrives at work at the long-term care center and is immediately faced with several activities that require attention. Which activity will the nurse attend to first?

• A. Task assignments for the day
• B. Stocking the medication closet
• C. A phone message from employee health services
• D. A phone message from a client's wife

Correct answer: A

Rationale: The nurse's priority should be attending to task assignments for the day. This ensures that client care can begin promptly and efficiently. Stocking the medication closet is important but can be done after ensuring task assignments are clear. Phone messages from employee health services and a client's wife, although important, can be addressed after organizing the staff for client care.

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