Nursing Elites

1. What is the primary purpose of administering Rho(D) immune globulin (RhoGAM) to an Rh-negative mother after childbirth?

• A. To prevent Rh sensitization in future pregnancies
• B. To treat anemia in the newborn
• C. To increase the mother's white blood cell count
• D. To prevent infection in the newborn

Correct answer: A

Rationale: The correct answer is A: To prevent Rh sensitization in future pregnancies. RhoGAM is given to an Rh-negative mother to prevent the development of antibodies against Rh-positive blood cells. This prevents Rh sensitization, which could lead to hemolytic disease in future Rh-positive pregnancies. Choices B, C, and D are incorrect because RhoGAM is not used to treat anemia in the newborn, increase the mother's white blood cell count, or prevent infection in the newborn.

2. A nurse is completing a focused assessment of an older adult's skin. The nurse notes a crusted 0.7 cm lesion on the client's forehead. Which action should the nurse take in response to this finding?

• A. Report the finding to the healthcare provider
• B. Place a clear occlusive dressing over the site
• C. Apply a warm compress to remove the crusted area
• D. Explain that this is a normal skin change with aging

Correct answer: A

Rationale: A crusted lesion, especially in an older adult, could be indicative of skin cancer or another serious condition. Therefore, reporting this finding to the healthcare provider is crucial for further evaluation and appropriate management. Placing an occlusive dressing (Choice B) could prevent proper assessment and treatment. Applying a warm compress (Choice C) may not be suitable for a suspicious skin lesion as it could worsen the condition. Explaining it as a normal skin change (Choice D) without proper evaluation can delay necessary interventions and potentially harm the patient.

3. A nurse who receives a patient in the operative suite prior to the actual surgery is in charge of the patient’s care. Which of the following is NOT a task related to the nurse’s intraoperative care?

• A. Go over the surgical procedure with the patient before he or she is anesthetized
• B. Strictly adhere to asepsis during all intraoperative procedures
• C. Provide emotional support to the patient and their family
• D. Monitor the patient’s physical status

Correct answer: A

Rationale: The correct answer is A. Going over the surgical procedure with the patient is typically done preoperatively, not intraoperatively. Intraoperative tasks of a nurse involve strictly adhering to asepsis during procedures, monitoring the patient's physical status, and providing emotional support to the patient and their family during the surgery. Choices B, C, and D are all tasks that are directly related to the nurse's responsibilities during the intraoperative phase of care.

4. A client has a prescription for a transcutaneous electrical nerve stimulator (TENS) unit for pain management during the postoperative period following a lumbar laminectomy. Which information should the nurse reinforce about the action of this adjuvant pain modality?

• A. The discharge of electricity will distract the client's focus from the pain
• B. An infusion of medication in the spinal canal will block pain perception
• C. Pain perception in the cerebral cortex is dulled by the unit's discharge of an electrical stimulus
• D. A mild electrical stimulus on the skin surface closes the gates of nerve conduction for severe pain

Correct answer: D

Rationale: The correct answer is D. TENS works by delivering a mild electrical stimulus to the skin, which can help close the 'gates' in the nervous system to block pain signals from reaching the brain, thus reducing pain perception. Choice A is incorrect because TENS does not distract from pain but rather helps manage it. Choice B is incorrect as it describes a different pain management technique involving medication in the spinal canal. Choice C is incorrect because TENS acts peripherally on nerve conduction rather than dulling pain perception in the cerebral cortex.

5. The UAP reports to the PN that a client refused to bathe for the third consecutive day. Which action is best for the PN to take?

• A. Explain the importance of good hygiene to the client
• B. Ask family members to encourage the client to bathe
• C. Reschedule the bath for the following day
• D. Ask the client why the bath was refused

Correct answer: D

Rationale: The best action for the PN to take when a client refuses to bathe is to ask the client why the bath was refused. Understanding the client's reasons for refusing a bath is crucial as it helps to address any underlying issues, such as fear, discomfort, or physical limitations. By communicating directly with the client, the PN can provide appropriate care tailored to the client's needs. Choices A, B, and C do not directly address the root cause of the refusal and may not effectively resolve the issue.

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