Nursing Elites

1. The healthcare professional prepares to administer buccal medication. The medicine should be placed...

• A. On the client's skin
• B. Between the client's cheeks and gums
• C. Under the client's tongue
• D. On the client's conjunctiva

Correct answer: B

Rationale: Buccal medication is administered by placing it between the client's cheeks and gums. This route allows for the medication to be absorbed through the mucous membranes in the mouth, providing a rapid onset of action compared to oral ingestion. Placing the medication under the tongue (sublingual) allows for absorption through the sublingual mucosa, not the buccal mucosa. Placing medication on the skin or the conjunctiva is not appropriate for buccal administration.

2. The healthcare professional is preparing to take vital signs in an alert client admitted to the hospital with dehydration secondary to vomiting and diarrhea. What is the best method used to assess the client’s temperature?

• A. Oral
• B. Axillary
• C. Radial
• D. Heat-sensitive tape

Correct answer: A

Rationale: The most accurate method for assessing temperature in an alert client is the oral method. It provides a more reliable reflection of the body's core temperature compared to axillary or radial methods. In cases of dehydration, it is important to get an accurate temperature reading to monitor the client's condition closely. Axillary temperature may be affected by environmental factors, while radial temperature measurement is not a standard method for assessing core body temperature. Heat-sensitive tape is not a recognized method for assessing body temperature in clinical practice.

3. What is another name for the knee-chest position?

• A. Genu-dorsal
• B. Genu-pectoral
• C. Lithotomy
• D. Sim’s

Correct answer: B

Rationale: The knee-chest position is correctly identified as the genu-pectoral position. In this position, a person rests on their knees and chest with the abdomen raised and the head turned to one side. This position is commonly used in medical examinations and procedures involving the rectal or pelvic areas, allowing for better visualization and access. Choice A, 'Genu-dorsal,' is incorrect as it does not refer to the knee-chest position. Choice C, 'Lithotomy,' is incorrect as it refers to a position where the patient is lying on their back with legs flexed and feet in stirrups, commonly used during childbirth or certain surgeries. Choice D, 'Sim’s,' is incorrect as it refers to a position where the patient lies on their left side with the right knee and thigh drawn up with the left arm placed along the back.

4. When caring for a client on pressure support ventilation (PSV), which statement by the nurse indicates an understanding of PSV?

• A. It keeps the alveoli open and prevents atelectasis.
• B. It allows preset pressure delivered during spontaneous ventilation.
• C. It guarantees minimal minute ventilator.
• D. It delivers a preset ventilatory rate and tidal volume to the client.

Correct answer: B

Rationale: Pressure support ventilation (PSV) is a mode that delivers a preset pressure when the client initiates a breath. This support helps the client to breathe spontaneously by reducing the work of breathing. The correct statement indicating an understanding of PSV is that it allows preset pressure to be delivered during spontaneous ventilation, as it assists the client's efforts without controlling the rate or volume of each breath.

5. When a chest tube is accidentally removed from a client, which of the following actions should the nurse NOT take first?

• A. Obtain a chest x-ray
• B. Apply sterile gauze to the insertion site
• C. Place tape around the insertion site
• D. Assess respiratory status

Correct answer: B

Rationale: When a chest tube is accidentally removed, the priority action for the nurse is to immediately seal the insertion site with a gloved hand, a sterile occlusive dressing, or petroleum gauze to prevent air from entering the pleural space and causing a pneumothorax. Applying sterile gauze to the insertion site is not the correct initial action. The first step is to prevent respiratory compromise by ensuring the site is sealed. Therefore, the nurse should not apply sterile gauze to the insertion site first.

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