Nursing Elites

1. What action by the nurse is appropriate when examining a 16-year-old male teenager?

• A. Discuss health teaching with the teenager to promote wellness.
• B. Ask the parent to step out of the room during the history and physical examination to respect the teenager's privacy.
• C. Use age-appropriate communication when speaking to the teenager to ensure understanding.
• D. Provide feedback that his body is developing normally and discuss the wide variation among teenagers on the rate of growth and development.

Correct answer: D

Rationale: During the examination of a 16-year-old male teenager, it is essential to provide feedback that his body is developing normally and to discuss the wide variation among teenagers regarding growth and development. This reassures the teenager about his health status and addresses any concerns about physical development. It is important to recognize that adolescents are very conscious of their body image and often compare themselves to their peers, hence the need for such feedback. Asking the parent to step out of the room respects the teenager's privacy and promotes open communication between the nurse and the teenager. Using age-appropriate communication is crucial to ensure that the teenager understands the information provided. Asking the parent to stay in the room may not be ideal as it can inhibit open discussion, and talking to the teenager as if they were a younger child is inappropriate and may undermine their autonomy and understanding.

2. A patient is having difficulty understanding how to properly run her glucose meter. Which of the following teaching methods would best help the patient understand how to use her instrument correctly?

• A. Give the patient an instruction booklet and encourage her to call the office if she has questions.
• B. Tell the patient to ask a healthcare provider to demonstrate how to use the instrument.
• C. Have the patient watch a video demonstrating the use of the instrument.
• D. Demonstrate the proper use of the instrument and then have the patient perform the process while still in the office.

Correct answer: D

Rationale: By using a demonstration and performance method of patient education, the patient is offered a chance to perform a task and have learning assessed while still in the office. This ensures that any questions that the patient has can be answered immediately, and any performance issues observed by the medical assistant can also be corrected promptly. Choice A is not as effective as providing a demonstration in person, as it may not address the patient's specific learning needs or allow for immediate feedback. Choice B suggests asking a healthcare provider to demonstrate, which is similar to the correct answer but may not always be readily available in the office. Choice C, watching a video, lacks the interactive component and immediate feedback that a live demonstration provides, making it less effective in this scenario.

3. Which of the following is an example of emotional abuse?

• A. A slap to the person's hand
• B. Threatening the person
• C. Ignoring and isolating a person
• D. Leaving a patient soiled for hours

Correct answer: C

Rationale: Emotional abuse involves behaviors that harm an individual's self-worth and emotional well-being. Threatening someone instills fear and causes psychological distress, making it a clear example of emotional abuse. Choices A, C, and D involve physical abuse, neglect, and neglect of care, respectively, rather than emotional abuse. A slap to the person's hand constitutes physical abuse, ignoring and isolating a person is neglectful behavior, and leaving a patient soiled for hours falls under neglect of care.

4. Which of the following actions is most appropriate for reducing the risk of infection during the post-operative period?

• A. Flush the central line with heparin at least every four hours
• B. Administer narcotic analgesics as needed
• C. Remove the urinary catheter as soon as the client is ambulatory
• D. Order a high-protein diet for the client

Correct answer: C

Rationale: The most appropriate action to reduce the risk of infection during the post-operative period is to remove the urinary catheter as soon as the client is ambulatory. Urinary catheters can serve as a source of bacteria, increasing the risk of infection in the bladder or urethra. By removing the catheter promptly once the client is mobile, the risk of infection can be minimized. Option A, flushing the central line with heparin, is not directly related to reducing urinary tract infections. Option B, administering narcotic analgesics as needed, is important for pain management but does not directly address infection prevention. Option D, ordering a high-protein diet, may be beneficial for wound healing but does not specifically target infection risk reduction in the post-operative period.

5. Rales and rhonchi are frequently noted during an examination of lung sounds. What is the difference between the two?

• A. Rales are louder.
• B. Rhonchi are noted only in infants.
• C. Rales occur on inspiration, rhonchi on expiration.
• D. Rales are noted only in infants.

Correct answer: C

Rationale: The correct answer is that rales occur on inspiration, while rhonchi occur on expiration. Rales are typically heard during inhalation when there is fluid in the alveoli or air passages. Rhonchi, on the other hand, are caused by air passing through obstructed airways during exhalation due to secretions in the respiratory tract. Choice A is incorrect because the loudness of the sounds is not the primary distinguishing factor between rales and rhonchi. Choice B is incorrect as rhonchi can be heard in individuals beyond infancy. Choice D is incorrect as rales can be present in patients of various age groups, not just infants.

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