Nursing Elites

1. Where will the nurse collect the most reliable source of pain assessment?

• A. From the nurse-to-nurse bedside report
• B. From a medical surgical book
• C. From the client
• D. From the client's chart

Correct answer: C

Rationale:

2. The nurse is planning care for a post-operative client after a total hip arthroplasty. What is the priority nursing intervention?

• A. Observe client for changes in mental status
• B. Use aseptic technique for wound care and emptying of drains
• C. Keep the client's heels off the bed
• D. Perform neurovascular assessments per protocol

Correct answer: D

Rationale:

3. An area of erythema on the child's skin is being assessed by the nurse. The nurse presses down on the area, and the area becomes white. What time does the nurse document for this finding?

• A. Non-blanching
• B. Blanching
• C. Redness
• D. Warmth

Correct answer: B

Rationale:

4. Which client is at highest risk of compromised immunity?

• A. A client who just had surgery
• B. A client who just delivered a baby
• C. A client with extreme anxiety
• D. A client who is awaiting surgery

Correct answer: A

Rationale:

5. The nurse Is teaching the client how to administer eye drops. Which of these actions indicates the need for further client education?

• A. The client sets the cap down in a manner that does not contaminate it.
• B. The client drops the prescribed number of drops into the conjunctival sac
• C. The client washes their hands before instilling the drops
• D. The client ensures that they touch the administration dropper to the eye

Correct answer: D

Rationale: Touching the dropper to the eye contaminates it and can lead to infection.

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