Nursing Elites

1. Nail and foot care are essential in meeting the basic hygiene needs of clients. Important assessments by the nurse in this area include:

• A. a full-body assessment is not specific to nail and foot care.
• B. the essential lab work of the client is not related to nail and foot assessments.
• C. the nail beds and the tissue surrounding the nails.
• D. foot corns and calluses only neglect other important aspects of nail and foot care.

Correct answer: C

Rationale: The correct answer is to assess the nail beds and the tissue surrounding the nails. This assessment is crucial to identify abnormal discoloration, lesions, paronychia, dryness, breaks in the skin, pressure areas, or any other unusual appearances. Choice A is incorrect as a full-body assessment is broader and not specific to nail and foot care. Choice B is incorrect as lab work is not directly related to nail and foot assessments. Choice D is incorrect as it focuses only on foot corns and calluses, neglecting other important aspects of nail and foot care.

2. A new nurse employed at a community hospital is reading the organization's mission statement. The new nurse understands that this statement is written for which purpose?

• A. To outline what the organization plans to accomplish
• B. To identify the policies and procedures of the organization
• C. To describe the benefits available to employees
• D. To define the rules of the organization that the employees must follow

Correct answer: A

Rationale: The correct answer is 'To outline what the organization plans to accomplish.' A mission statement expresses the purpose or reason for an organization's existence, outlining what it aims to achieve. It often includes statements of philosophy, purpose, and goals. This statement serves as a benchmark for evaluating the organization's performance. The mission statement is not meant to identify policies and procedures (Choice B) or describe employee benefits (Choice C). Choice B specifies the administrative guidelines and protocols of the organization, while Choice C pertains to the perks available to employees. Choice D is incorrect as the rules of the organization that employees must follow are usually detailed in employee handbooks or codes of conduct, not in the mission statement.

3. When planning play activities for a hospitalized school-age child, a nurse uses Erikson's theory of psychosocial development to select an appropriate activity. The nurse selects an activity that will assist the child in developing which developmental goal?

• A. A sense of industry
• B. Autonomy
• C. A sense of trust
• D. Initiative

Correct answer: C

Rationale: The correct answer is 'A sense of industry.' According to Erikson, the central task of the school-age years is the development of a sense of industry. During this stage, children engage in activities like schoolwork, crafts, chores, hobbies, and sports to develop a sense of competence and productivity. The development of trust is the primary task of infancy, autonomy is the task of toddlerhood, and initiative is the task of the preschool years. Therefore, in this scenario, focusing on fostering a sense of industry aligns with the developmental goals of a school-age child.

4. A nurse is planning the assignments for the shift. Which task should the nurse assign to the nursing assistant?

• A. Monitoring the vital signs for a client who needs a blood transfusion
• B. Performing hygiene for a client with diarrhea on whom contact precautions have been imposed
• C. Performing a dressing change on a client with a draining abdominal wound that requires frequent dressing changes
• D. Ambulating a client with angina who needs to be ambulated for the first time since admission

Correct answer: B

Rationale: When assigning tasks, a nurse should consider the job description of the nursing assistant, their clinical competence, and state law. Monitoring vital signs for a client needing a blood transfusion, performing a dressing change on a client with a draining wound, and ambulating a client with angina are tasks that require a licensed nurse's skill. On the other hand, providing hygiene care for a client with diarrhea under contact precautions is a task suitable for a nursing assistant. Nursing assistants are trained to provide hygiene care effectively and manage clients under specific precautions, making this task appropriate for them.

5. What is a significant point about Shigella that the nurse should acknowledge upon identifying it in a stool culture?

• A. People who have been in contact with the client need to be tested.
• B. Shigella is an airborne infection.
• C. Shigella is a bacteria sometimes found in stagnant water.
• D. The nurse should wear a one-way breathing apparatus when giving client care.

Correct answer: C

Rationale: Shigella is a bacteria sometimes found in stagnant water. Transmission of Shigella is typically oral-fecal, so good hand washing and the use of gloves are the best means of prevention when caring for a client with Shigella. The bacteria can be found in food and water contaminated by fecal material. Incidences of Shigella are reportable in many states. Choices A, B, and D are incorrect. While it is important for close contacts to be aware and practice good hygiene, testing is not routinely indicated. Shigella is not an airborne infection; it is transmitted through contaminated food or water. A one-way breathing apparatus is not necessary for caring for a patient with Shigella; standard precautions, including handwashing and gloves, are sufficient.

Similar Questions