Nursing Elites

1. What is the most common injury among elderly persons?

• A. Atherosclerotic changes in the blood vessels
• B. Increased incidence of gallbladder disease
• C. Urinary Tract Infection
• D. Hip fracture

Correct answer: D

Rationale: Hip fracture is the most common injury among elderly persons. As people age, their bones become more fragile, making them more susceptible to hip fractures, often resulting from falls. These fractures can significantly impact an elderly person's quality of life and mobility, making them a significant concern in geriatric care.

2. What term refers to the manner of walking?

• A. Gait
• B. Range of motion
• C. Flexion and extension
• D. Hopping

Correct answer: A

Rationale: Gait specifically refers to the manner in which a person walks. It encompasses the pattern, rhythm, and style of walking, making it the most appropriate term in this context. Choices B, C, and D are incorrect. Range of motion refers to the extent of movement of a joint, flexion and extension relate to bending and straightening movements at a joint, and hopping is a specific type of movement that involves jumping on one foot.

3. To assess the kidney function of a patient with an indwelling urinary (Foley) catheter, the nurse measures the hourly urine output. When should she notify the physician?

• A. Less than 30 ml/hour
• B. 64 ml in 2 hours
• C. 90 ml in 3 hours
• D. 125 ml in 4 hours

Correct answer: A

Rationale: Notifying the physician is necessary when the urine output is less than 30 ml/hour as it indicates impaired kidney function. Adequate urine output is essential for monitoring kidney function, and a urine output less than 30 ml/hour could suggest potential renal issues that require medical attention.

4. A client is to receive a transfusion of packed RBCs. Which of the following actions should the nurse take?

• A. Prime IV tubing with 0.9% sodium chloride
• B. Use a 24-gauge IV catheter
• C. Obtain filterless IV tubing
• D. Place blood in the warmer for 1 hr

Correct answer: A

Rationale: Prior to administering a blood transfusion, it is essential to prime the IV tubing with 0.9% sodium chloride to prevent hemolysis of the blood cells. Using a smaller gauge IV catheter (e.g., 20 or 22 gauge) is recommended for blood transfusions to prevent hemolysis. Filterless IV tubing is contraindicated for blood transfusions as it does not have a filter to trap potential blood clots or debris. Warming blood is unnecessary and could lead to the development of bacteria in the blood product. Therefore, the correct action for the nurse to take is to prime the IV tubing with 0.9% sodium chloride.

5. Why is a precise amount of oxygen necessary for a patient with COPD to prevent which complication?

• A. Cardiac arrest related to increased partial pressure of carbon dioxide in arterial blood (PaCO2)
• B. Circulatory overload due to hypervolemia
• C. Respiratory excitement
• D. Inhibition of the respiratory hypoxic stimulus

Correct answer: D

Rationale: In patients with COPD, the respiratory drive is often stimulated by low oxygen levels. Administering too much oxygen can inhibit this hypoxic drive, leading to respiratory depression and potential respiratory failure. Therefore, it is crucial to carefully regulate the oxygen therapy to prevent the inhibition of the respiratory hypoxic stimulus in COPD patients.

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