Nursing Elites

1. A nurse is evaluating a client’s use of a cane. What is the correct use?

• A. Client holds the cane on the stronger side of the body.
• B. Client holds the cane on the weaker side of the body.
• C. Client holds the cane in front of the weaker side of the body.
• D. Client holds the cane in front of the stronger side of the body.

Correct answer: A

Rationale: The correct way to use a cane is for the client to hold it on the stronger side of the body. This positioning allows the cane to provide support to the weaker side, assisting with balance and stability. Placing the cane on the weaker side (Choice B) may not provide adequate support and could lead to an increased risk of falls. Holding the cane in front of the weaker side (Choice C) or in front of the stronger side (Choice D) does not optimize the support and stability needed while walking with a cane.

2. A healthcare professional is preparing to administer dextrose 5% in water (D5W) 1,000-mL IV to infuse over 10 hr. How many mL/hr should the IV infusion pump be set to deliver? (Round the answer to the nearest whole number. Do not use a trailing zero.)

• A. 100 mL/hr
• B. 150 mL/hr
• C. 75 mL/hr
• D. 50 mL/hr

Correct answer: A

Rationale: To infuse 1,000 mL over 10 hr, the IV pump should be set to deliver 100 mL/hr. This calculation is derived by dividing the total volume (1,000 mL) by the total time in hours (10 hr), resulting in the infusion rate of 100 mL/hr. Choices B, C, and D are incorrect as they do not accurately reflect the correct calculation for this scenario.

3. The healthcare provider is assessing a client with a diagnosis of chronic obstructive pulmonary disease (COPD). Which assessment finding would be most concerning?

• A. Barrel chest
• B. Clubbing of the fingers
• C. Cough with sputum production
• D. Use of accessory muscles

Correct answer: D

Rationale: The use of accessory muscles is the most concerning finding in a client with COPD. It indicates increased work of breathing and may signal respiratory distress, requiring immediate attention. Barrel chest is a common physical characteristic in individuals with COPD due to chronic air trapping and hyperinflation of the lungs but is not as acutely concerning as the use of accessory muscles. Clubbing of the fingers is a late sign of chronic hypoxia and is often seen in conditions with prolonged hypoxemia but is not as acute as the use of accessory muscles. Cough with sputum production is a common symptom in COPD due to excess mucus production but does not indicate immediate respiratory distress as the use of accessory muscles does.

4. To ensure client safety, a nurse manager is planning to observe a newly licensed nurse perform a straight catheterization on a client. In which of the following roles is a nurse manager functioning?

• A. Case manager - responsible for overseeing a case load of clients but does not provide direct client care
• B. Client educator
• C. Client advocate
• D. Supervisor

Correct answer: D

Rationale: The correct answer is D: Supervisor. In this scenario, the nurse manager is acting as a supervisor to oversee and ensure the newly licensed nurse performs the straight catheterization correctly, following protocols, and maintaining client safety. A supervisor role involves monitoring and guiding staff in their duties to ensure quality care. Choices A, B, and C are incorrect. A case manager typically manages a case load of clients but does not provide direct care like in this situation. Client educator and client advocate roles do not directly relate to supervising or overseeing a procedure being performed by another nurse.

5. When admitting an older adult client who is Hispanic, which of the following cultural considerations should the nurse include when developing the plan of care?

• A. The Hispanic culture views late adulthood as a time of wisdom and experience
• B. The Hispanic culture expects adult children to care for older adult parents
• C. The Hispanic culture identifies the eldest female family member as the decision maker
• D. The Hispanic culture expects individuals to make their own decisions when death is imminent

Correct answer: B

Rationale: In Hispanic culture, there is an expectation that adult children will care for their older parents, emphasizing a strong family support system. This cultural value highlights the importance of filial piety and respect for elders within the family structure. Choice A is incorrect because Hispanic culture generally values late adulthood as a time of wisdom and experience, not a negative time. Choice C is incorrect as Hispanic culture typically involves collective family decision-making rather than assigning decision-making solely to the eldest female member. Choice D is incorrect as Hispanic culture values family support and involvement in end-of-life decisions rather than individual decision-making.

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