Nursing Elites

1. What is the primary function of hemoglobin in red blood cells?

• A. Oxygen transport
• B. Immunity
• C. Blood clotting
• D. Carbon dioxide transport

Correct answer: A

Rationale: The correct answer is A: Oxygen transport. Hemoglobin in red blood cells binds to oxygen in the lungs and carries it to tissues throughout the body, releasing it where needed. This process is essential for cellular respiration and energy production. Choices B, C, and D are incorrect because hemoglobin's primary function is not related to immunity, blood clotting, or carbon dioxide transport. Hemoglobin's main role is to transport oxygen, ensuring adequate oxygen supply to body tissues for metabolic processes.

2. A client with a recent total knee replacement is scheduled for physical therapy. The client refuses to participate, stating that the pain is too intense. What should the nurse do first?

• A. Administer the prescribed analgesic and encourage participation after it takes effect.
• B. Reschedule the physical therapy session for later in the day.
• C. Explain the importance of physical therapy for recovery.
• D. Notify the physical therapist of the client's refusal.

Correct answer: A

Rationale: Administering pain medication before physical therapy helps manage the pain, making it easier for the client to participate in the necessary exercises to improve recovery and prevent complications such as joint stiffness. Choice B is not the first step as addressing the pain should take precedence. Choice C is important but should come after managing the pain to facilitate participation. Choice D involves another healthcare provider and is not the immediate action needed in this situation.

3. The practical nurse is caring for a client who had a total laryngectomy, left radical neck dissection, and tracheostomy. The client is receiving nasogastric tube feedings via an enteral pump. Today the rate of feeding is increased from 50 ml/hr to 75 ml/hr. What parameter should the PN use to evaluate the client's tolerance to the rate of the feeding?

• A. Daily weight
• B. Gastric residual volumes
• C. Bowel sounds
• D. Urinary and stool output

Correct answer: B

Rationale: Monitoring gastric residual volumes helps to assess how well the client is tolerating the increased feeding rate. High residuals may indicate delayed gastric emptying, which could lead to complications like aspiration. This helps in adjusting the feeding plan as necessary. Daily weight (Choice A) is not the most appropriate parameter to evaluate tolerance to feeding rate changes. Bowel sounds (Choice C) and urinary/stool output (Choice D) are important assessments but do not directly indicate tolerance to enteral feeding rate changes.

4. The nurse is assisting the recreational director of a long-term care facility in planning outdoor activities for the wheelchair-bound older residents who are mentally alert. Which activity meets the physical and social needs of these residents?

• A. An open-air concert
• B. A tea party in the courtyard
• C. A team ring-toss competition
• D. A picnic in the park

Correct answer: B

Rationale: A tea party in the courtyard provides a social and physical activity suitable for wheelchair-bound older residents who are mentally alert. It offers an opportunity for social interaction, enjoyment of the outdoors, and participation in a physical activity without the need for extensive mobility. An open-air concert may not provide the same level of social interaction or physical engagement as a tea party. A team ring-toss competition may be physically challenging for wheelchair-bound residents. A picnic in the park could present challenges related to accessibility and might not foster the same level of social interaction as a tea party in a more contained courtyard setting.

5. An adult client is undergoing weekly external radiation treatments for breast cancer and reports increasing fatigue. What action should the nurse take?

• A. Notify the healthcare provider or charge nurse immediately
• B. Offer to reschedule the treatment for the following week
• C. Plan to monitor the client's vital signs every 30 minutes
• D. Reinforce the need for extra rest periods and plenty of sleep

Correct answer: D

Rationale: The correct action for the nurse to take when a client undergoing radiation treatment for breast cancer reports increasing fatigue is to reinforce the need for extra rest periods and plenty of sleep. Fatigue is a common side effect of radiation therapy, and adequate rest and sleep can help manage this symptom. Notifying the healthcare provider or charge nurse immediately (choice A) is not necessary for increasing fatigue, as it is expected during radiation therapy. Offering to reschedule the treatment for the following week (choice B) is not the best initial action for managing fatigue. Planning to monitor the client's vital signs every 30 minutes (choice C) is unnecessary and not directly related to managing fatigue caused by radiation therapy.

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