Nursing Elites

1. The healthcare provider is preparing to use an otoscope for an examination. Which statement is true regarding the otoscope?

• A. Often used to direct light into the sinuses
• B. Used to examine the structures of the internal ear
• C. Uses a short, broad speculum to help visualize the ear
• D. Directs light into the ear canal and onto the tympanic membrane

Correct answer: D

Rationale: The otoscope is a tool used to examine the ear canal and tympanic membrane, which separates the external and middle ear. It is not intended to direct light into the sinuses or examine the internal structures of the ear. The otoscope typically uses a short, narrow speculum to aid in visualizing the ear canal and tympanic membrane, not a short, broad speculum as mentioned in choice C.

2. While caring for Mrs. Thomas, you see a notation on the nursing care plan that states 'ambulate at least 10 yards qid'. This patient will be assisted with ambulation at which of the following times?

• A. 10:00 AM
• B. 10 am and 2 pm
• C. 10 am and 2 pm
• D. 10 am, 2 pm, 6 pm, and 10 pm

Correct answer: D

Rationale: The correct answer is to assist the patient with ambulation at 10 am, 2 pm, 6 pm, and 10 pm as qid stands for four times per day. This schedule is commonly followed in healthcare facilities to ensure regular ambulation and exercise for the patient. Choices A, B, and C do not cover all the specified times for ambulation as indicated by the qid notation on the care plan.

3. In a patient with acromegaly, which assessment finding will the nurse expect to find?

• A. Sternal deformity and hyperextensible joints
• B. Growth retardation and a delayed onset of puberty
• C. Overgrowth of bone in the face, head, hands, and feet
• D. Increased height and weight and delayed sexual development

Correct answer: C

Rationale: Acromegaly is a condition characterized by excessive secretion of growth hormone in adulthood after normal body growth completion. This hormonal excess leads to overgrowth of bones in the face, head, hands, and feet; however, there is no significant change in height. Stating sternal deformity and hyperextensible joints is incorrect as they are characteristic findings of Marfan syndrome. Growth retardation and delayed onset of puberty are not typical of acromegaly but are seen in hypopituitary dwarfism. Increased height, weight, and delayed sexual development are features of gigantism, not acromegaly. Therefore, the correct assessment finding in a patient with acromegaly would be overgrowth of bone in the face, head, hands, and feet.

4. What is the minimum amount of personal protective equipment for a nurse when working with a newborn immediately after a high-risk delivery in a client's room?

• A. Sterile gown, gloves
• B. Mask, gown, shoe covers
• C. Gloves
• D. Hat, mask, gloves, gown, shoe covers

Correct answer: C

Rationale: The correct answer is gloves. When attending a high-risk delivery and handling a newborn immediately after birth, the minimum personal protective equipment required for a nurse includes gloves. This is essential to protect the nurse from potential exposure to the mother's blood or body fluids that may be present on the newborn's skin. Choices A, B, and D include additional protective equipment that is not necessary for this specific scenario. Wearing gloves is crucial for infection control and to prevent the transmission of pathogens.

5. The client is a chronic carrier of infection. To prevent the spread of the infection to other clients or healthcare providers, the nurse emphasizes interventions that do which of the following? (Berman & Snyder, 2012, p. 713)

• A. Eliminate the reservoir
• B. Block the portal of exit from the reservoir
• C. Block the portal of entry into the host
• D. Decrease the susceptibility of the host

Correct answer: B

Rationale: To prevent the spread of infection from a chronic carrier, the nurse should focus on blocking the portal of exit from the reservoir, which is the carrier person. By preventing the movement of the organism from the reservoir, the infection can be contained. Eliminating the reservoir is not feasible in this case as the carrier is a chronic carrier. Blocking the portal of entry into the host or decreasing the susceptibility of the host would only impact individual prevention and not the spread from the carrier to others.

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