Nursing Elites

1. What should the charge nurse do after overhearing the patient care assistant speaking harshly to the client with dementia?

• A. Change the patient care assistant's assignment
• B. Explore the interaction with the patient care assistant
• C. Discuss the matter with the client's family
• D. Initiate a group session with the patient care assistant

Correct answer: B

Rationale: The best action for the charge nurse to take is to explore the interaction with the patient care assistant. This step allows for clarification of the situation and direct addressing of the issue. Changing the patient care assistant's assignment (choice A) might be necessary, but understanding the situation should come first. Discussing the matter with the client's family (choice C) as an initial step could escalate the situation. Initiating a group session with the patient care assistant (choice D) could be considered later as a preventive measure to avoid similar incidents in the future.

2. A 20-year-old female has a prescription for tetracycline. While teaching the client how to take her medicine, the nurse learns that the client is also taking Ortho-Novum oral contraceptive pills. Which instructions should be included in the teaching plan?

• A. The oral contraceptives will decrease the effectiveness of the tetracycline.
• B. Nausea often results from taking oral contraceptives and antibiotics.
• C. Toxicity can result when taking these two medications together.
• D. Antibiotics can decrease the effectiveness of oral contraceptives, so the client should use an alternate method of birth control.

Correct answer: D

Rationale: When antibiotics and oral contraceptives are taken together, the effectiveness of the oral contraceptives can be reduced, increasing the risk of pregnancy. Therefore, it is important to advise the client to use an alternate method of birth control to prevent unintended pregnancy. Choices A, B, and C are incorrect because there is no evidence to suggest that oral contraceptives decrease the effectiveness of tetracycline, cause nausea, or result in toxicity when taken with antibiotics.

3. A corporate executive works 60-80 hours a week. The client is experiencing some physical signs of stress. The nurse teaches the client biofeedback techniques. This is an example of which of the following health-promotion interventions?

• A. structure
• B. relaxation technique
• C. time management
• D. regular exercise

Correct answer: C

Rationale: The correct answer is 'relaxation technique.' Biofeedback techniques are a form of relaxation technique that can help individuals quiet the mind, release tension, and counteract responses to stress. Teaching biofeedback techniques to the client aims to promote relaxation and stress management. Choice A, 'structure,' does not directly relate to teaching biofeedback techniques. Choice C, 'time management,' focuses on organizing tasks efficiently, not on relaxation techniques. Choice D, 'regular exercise,' although beneficial for overall health, is not specifically related to the teaching of biofeedback techniques for stress relief.

4. What is the purpose of a contract between a nurse and a client?

• A. Contracts specify the participation and responsibilities of both parties.
• B. Contracts indicate the feeling tone established between participants.
• C. Contracts are legally binding and prevent either party from ending the relationship prematurely.
• D. Contracts define the roles the participants take.

Correct answer: A

Rationale: The purpose of a contract between a nurse and a client is to specify the participation and responsibilities of both parties. It outlines the expectations, contributions, and duties of each party involved in the professional relationship. This ensures clarity and mutual understanding. Choice B is incorrect as contracts do not indicate feeling tone but rather focus on the professional aspects. Choice C is incorrect because while contracts are legally binding, their primary purpose is not to prevent premature termination but to establish guidelines. Choice D is incorrect as contracts focus more on responsibilities and participation rather than specific roles.

5. The nurse is caring for a client scheduled for a surgical repair of a sacular abdominal aortic aneurysm. Which assessment is most crucial during the preoperative period?

• A. Assessment of the client's level of anxiety
• B. Evaluation of the client's exercise tolerance
• C. Identification of peripheral pulses
• D. Assessment of bowel sounds and activity

Correct answer: C

Rationale: The most crucial assessment during the preoperative period for a client with a sacular abdominal aortic aneurysm scheduled for surgical repair is the identification of peripheral pulses. During surgery, the aorta will be clamped, potentially affecting blood circulation to the kidneys and lower extremities. Therefore, it is essential for the nurse to assess peripheral pulses and monitor the return of circulation to the lower extremities postoperatively. Assessing the client's level of anxiety (Choice A) is important but not as crucial as ensuring adequate circulation. Evaluating exercise tolerance (Choice B) is not recommended preoperatively for this situation. Assessing bowel sounds and activity (Choice D) is of lesser concern compared to the critical need to monitor peripheral circulation.

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