Nursing Elites

1. The correct method for determining the vastus lateralis site for I.M. injection is to:

• A. Locate the upper aspect of the upper outer quadrant of the buttock about 5 to 8 cm below the iliac crest
• B. Palpate the lower edge of the acromion process and the midpoint lateral aspect of the arm
• C. Palpate a 1” circular area anterior to the umbilicus
• D. Divide the area between the greater femoral trochanter and the lateral femoral condyle into thirds, and select the middle third on the anterior of the thigh

Correct answer: D

Rationale: The vastus lateralis site is located in the middle third of the thigh.

2. A healthcare professional is preparing to administer a dose of a new prescription of prednisone to a client who has COPD. The healthcare professional should not concentrate on which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Tachycardia
• C. Fluid retention
• D. Black, tarry stools

Correct answer: B

Rationale: When administering prednisone, a corticosteroid medication, to a client with COPD, the healthcare professional should be aware of potential adverse effects. Tachycardia is not a common adverse effect of prednisone use. The correct adverse effects to monitor for include hypokalemia, fluid retention, and gastrointestinal issues like black, tarry stools due to potential gastrointestinal bleeding. Therefore, the healthcare professional should not concentrate on tachycardia but should focus on the other listed adverse effects when administering prednisone to a client with COPD.

3. When planning care for a client on mechanical ventilation, which mode of ventilation that increases the effort of the client's respiratory muscles should NOT be included in the plan of care?

• A. Assist-control
• B. Synchronized intermittent mandatory ventilation
• C. Continuous positive airway pressure
• D. Pressure support ventilation

Correct answer: A

Rationale: Assist-control ventilation mode delivers a preset tidal volume at a set rate; however, it may not be suitable for clients who need to maintain some level of respiratory muscle activity. This mode provides full support for each breath, potentially leading to decreased respiratory muscle strength over time. Therefore, it is important to avoid using assist-control mode for clients who require increased effort of respiratory muscles to prevent muscle atrophy and promote optimal respiratory function.

4. A healthcare professional is reviewing ABG laboratory results of a client who is in respiratory distress. The results are pH 7.47, PaCO2 32 mm Hg, and HCO3 22 mm Hg. The healthcare professional should recognize that the client is experiencing which of the following acid-base imbalances?

• A. Respiratory acidosis
• B. Respiratory alkalosis
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: B

Rationale: The ABG results show a high pH (alkalosis) along with low PaCO2 and normal HCO3 levels, indicating respiratory alkalosis. In this condition, there is excessive loss of carbon dioxide (as seen by the low PaCO2) leading to a decrease in carbonic acid concentration and subsequent increase in pH. Metabolic acidosis or alkalosis would involve primary changes in bicarbonate levels, which are not predominant in this case.

5. A healthcare professional is providing information about tuberculosis to a group of clients at a local community center. Which of the following manifestations should the professional NOT include in the teaching?

• A. Persistent cough
• B. Weight gain
• C. Fatigue
• D. Night sweats

Correct answer: B

Rationale: Weight gain is not a typical manifestation of tuberculosis. The characteristic symptoms of tuberculosis include a persistent cough, fatigue, and night sweats. Weight loss, not weight gain, is a common symptom associated with tuberculosis due to the impact of the infection on the body's metabolism. Therefore, the healthcare professional should exclude weight gain from the teaching on tuberculosis manifestations.

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