Nursing Elites

1. In an obstetrical emergency, which of the following actions should the nurse perform first after the baby delivers?

• A. Place extra padding under the mother to absorb blood from the delivery.
• B. Cut the umbilical cord using sterile scissors.
• C. Suction the baby's mouth and nose.
• D. Wrap the baby in a clean blanket to preserve warmth.

Correct answer: C

Rationale: In an obstetrical emergency, the immediate action the nurse should take after the baby delivers is to suction the baby's mouth and nose to ensure the infant can breathe properly. This helps clear any potential obstructions and establish a clear airway. Cutting the umbilical cord (Choice B) and wrapping the baby in a clean blanket (Choice D) are important steps but should come after ensuring the baby's airway is clear. Placing extra padding under the mother (Choice A) is not a priority in this emergency situation as the focus should be on the baby's immediate needs for breathing and airway clearance.

2. Which of the following lab values is associated with a decreased risk of cardiovascular disease?

• A. high HDL cholesterol
• B. low HDL cholesterol
• C. low total cholesterol
• D. low triglycerides

Correct answer: B

Rationale: High HDL cholesterol is associated with a decreased risk of cardiovascular disease because HDL cholesterol is known as 'good' cholesterol. It helps remove other forms of cholesterol, like LDL cholesterol, from the bloodstream, reducing the risk of plaque buildup in the arteries. Low HDL cholesterol (Choice B) is actually a risk factor for cardiovascular disease because it means there is less of the 'good' cholesterol to perform its protective functions. Low total cholesterol (Choice C) and low triglycerides (Choice D) are not necessarily associated with a decreased risk of cardiovascular disease, as the balance and types of cholesterol play a more crucial role in heart health.

3. What is the appropriate ratio of cardiac compressions to ventilations in an adult client for one-person CPR?

• A. 5:01
• B. 1:05
• C. 15:02
• D. 2:15

Correct answer: C

Rationale: The correct answer is 15:2. For one-person CPR on an adult, the ratio of compressions to ventilations is 15:2. This ratio ensures adequate oxygenation while maintaining effective circulation. Choice A (5:1) and Choice B (1:5) are incorrect ratios and do not align with the recommended guidelines for adult CPR. Choice D (2:15) is also incorrect as it reverses the order of compressions and ventilations.

4. A small amount of bubbling is seen in the water seal of a pleural drainage system when a client coughs. What should the nurse do?

• A. Consider it a normal finding.
• B. Check the system for leaks.
• C. Clamp the chest tube.
• D. Change the drainage system.

Correct answer: A

Rationale: A small amount of bubbling is a normal finding in the water seal of a pleural drainage system when a client coughs. It is only a problem to find continuous, excessive bubbling in the water seal, which indicates a leak. Checking the system for leaks would be appropriate if there is continuous, excessive bubbling. Clamping the chest tube or changing the drainage system is not necessary in response to a small amount of bubbling during a cough, as this is considered a normal finding.

5. To what does legal protection of confidentiality extend?

• A. Written documentation only.
• B. Electronic dissemination of information not identifiable to a specific client.
• C. Only within the court system.
• D. Both written and verbal information.

Correct answer: D

Rationale: Legal protection of confidentiality extends to both written and verbal information that is identifiable as individual private health information. Confidentiality in healthcare settings is vital to protect patients' privacy and trust. Choice A is incorrect because legal protection covers verbal information as well, not just written documentation. Choice B is incorrect as it mentions information not identifiable to a specific client, which wouldn't fall under legal protection of confidentiality. Choice C is incorrect as confidentiality extends beyond just the court system, impacting various healthcare settings and interactions. Therefore, the correct answer is D.

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