Nursing Elites

1. A nurse working in an orthopedic unit is caring for 4 clients. Which of the following clients should the nurse identify as being at highest risk for skin breakdown?

• A. An adolescent who has a patella fracture and is in an immobilizer
• B. A young adult who has a femur fracture and is going to surgery in two hours
• C. A middle-aged adult who has fractured his radius and has a cast
• D. An older adult who has a hip fracture and is immobile

Correct answer: D

Rationale:

2. What medication class can decrease tissue inflammation but delays bone healing?

• A. Anticoagulants
• B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
• C. Opioids
• D. Narcotics

Correct answer: B

Rationale: The correct answer is B: Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are known to decrease tissue inflammation but may delay bone healing. Anticoagulants (Choice A) are used to prevent blood clotting, opioids (Choice C) are pain relievers, and narcotics (Choice D) are drugs that affect the central nervous system. While all the choices may have their own indications and uses in healthcare, NSAIDs are specifically associated with delaying bone healing despite their anti-inflammatory properties.

3. A client does not understand why vision loss due to glaucoma is irreversible. What is the nurse's best explanation?

• A. Once retinal detachment occurs, it does not return to its normal state
• B. Once the tissue has necrosed from high-pressure, it does not regenerate
• C. Glaucoma always leads to permanent blindness
• D. Once bacterial infection has caused damage, the tissue does not regenerate

Correct answer: B

Rationale: The correct explanation for irreversible vision loss in glaucoma is that once the tissue has necrosed from high pressure, it does not regenerate. This necrosis occurs due to the damage caused by increased intraocular pressure, which leads to irreversible damage to the optic nerve and retinal tissue. Choices A, C, and D are incorrect because they do not directly address the specific mechanism of irreversible vision loss in glaucoma, which is necrosis due to high pressure.

4. A nurse is caring for an intubated and sedated geriatric client. What intervention is most appropriate for reducing the risk for a friction and shear injury?

• A. Use a mechanical lift to reposition the client every 2 hours
• B. Elevate the client's head of the bed to 45 degrees
• C. Postpone daily bed bath
• D. Caregiver independently slides the client up in the bed

Correct answer: A

Rationale:

5. A nurse is teaching a newly hired group of unlicensed assistive personnel about infection-control measures on the unit. What is the most effective way to prevent the spread of pathogens during client care?

• A. Properly dispose of contaminated equipment
• B. Perform hand hygiene
• C. Discard used syringes into appropriate containers
• D. Change soiled linens

Correct answer: B

Rationale:

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