Nursing Elites

1. The home health nurse is planning for the day's visits. Which client should be seen first?

• A. The 78-year-old who had a gastrectomy 3 weeks ago with a PEG tube
• B. The 5-month-old discharged 1 week ago with pneumonia who is being treated with amoxicillin liquid suspension
• C. The 50-year-old with MRSA being treated with Vancomycin via a PICC line
• D. The 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter

Correct answer: D

Rationale: The priority client is the 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter. This client is at the highest risk for complications and requires immediate attention. Choice C, the 50-year-old with MRSA being treated with Vancomycin via a PICC line, is incorrect as Vancomycin administration can be scheduled at specific times and does not indicate an urgent need for a visit. Choices A and B are also incorrect as these clients are more stable compared to the client with multiple sclerosis in need of cortisone therapy.

2. After talking to the nurse, the charge nurse should:

• A. Report the incident to the Board of Nursing
• B. File a formal reprimand
• C. Terminate the nurse
• D. Charge the nurse with a tort

Correct answer: B

Rationale: The appropriate action after discussing the problem with the nurse is to document the incident and file a formal reprimand. Reporting to the Board of Nursing may be necessary if the behavior persists or harm occurs to the client, but it is not the initial step. Termination should be considered if the issue continues despite warnings. Charging the nurse with a tort is not a suitable course of action in this situation as a tort refers to a wrongful act against a client or their belongings, not an appropriate disciplinary measure. Therefore, choices A, C, and D are incorrect.

3. A home health nurse is making preparations for morning visits. Which one of the following clients should the nurse visit first?

• A. A client with brain attack (stroke) receiving tube feedings
• B. A client with congestive heart failure complaining of nighttime dyspnea
• C. A client who had a thoracotomy 6 months ago
• D. A client with Parkinson’s disease

Correct answer: B

Rationale: The correct answer is B. The client with congestive heart failure complaining of nighttime dyspnea should be seen first as airway management is a priority in nursing care. This client's symptoms indicate potential respiratory distress, requiring immediate attention. Choices A, C, and D involve clients who are more stable and do not present with urgent or acute conditions that require immediate intervention. Choice A with a client receiving tube feedings for a stroke may require attention, but the urgency of addressing potential respiratory distress in choice B takes precedence. Choice C, a client who had a thoracotomy 6 months ago, unless presenting with acute distress, does not necessitate immediate attention. Choice D, a client with Parkinson's disease, is usually a chronic condition that does not typically require immediate intervention for the described scenario.

4. During discharge teaching for a client with diverticulitis on a low-roughage diet, which food should be eliminated from the diet?

• A. Roasted chicken
• B. Noodles
• C. Cooked broccoli
• D. Custard

Correct answer: C

Rationale: The client with diverticulitis needs to avoid gas-forming foods that can increase abdominal discomfort. Cooked broccoli is a high-fiber food that can worsen symptoms. Roasted chicken, noodles, and custard are suitable choices for a low-roughage diet as they are less likely to cause gas formation or abdominal discomfort.

5. A woman asks, "How much alcohol can I safely drink while pregnant?"? The nurse's best response is:

• A. "The amount of alcohol that is safe during pregnancy is unknown."?
• B. "Consuming one or two beers or glasses of wine a day is considered safe for a healthy pregnant woman."?
• C. "Drinking three or more drinks on any given occasion is the only harmful type of drinking during pregnancy."?
• D. "You can have a drink to help you relax and get to sleep at night."?

Correct answer: A

Rationale: The correct answer is, "The amount of alcohol that is safe during pregnancy is unknown."? It is crucial for pregnant women to avoid alcohol as there is no known safe amount during pregnancy. Consuming any amount of alcohol can harm the developing fetus and increase the risk of fetal alcohol syndrome, a condition characterized by mental and physical abnormalities in infants. Choices B, C, and D are incorrect because they provide misleading information that can potentially harm the fetus. Pregnant women should abstain from alcohol to ensure the health and well-being of their baby.

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