Nursing Elites

1. A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first?

• A. Remove the restraints from the client's wrists
• B. Review the chart for nonrestraint alternatives for agitation
• C. Speak with the AP about the incident
• D. Inform the unit manager of the incident

Correct answer: A

Rationale: The correct action for the nurse to take first is to remove the restraints from the client's wrists. Restraints should not be applied without a prescription due to the risk of harm to the client. Removing the restraints promptly is a priority to ensure the client's safety. Reviewing nonrestraint alternatives, speaking with the AP, and informing the unit manager can follow after ensuring the client's immediate safety by removing the restraints.

2. A client with DM has an above-knee amputation because of severe peripheral vascular disease. Two days following surgery, when preparing the client for dinner, what is the nurse's primary responsibility?

• A. Check the client's serum glucose level
• B. Assist the client out of bed to the chair
• C. Place the client in a high-Fowler's position
• D. Ensure that the client's residual limb is elevated

Correct answer: A

Rationale: The correct answer is to check the client's serum glucose level. In a client with diabetes who just had surgery, monitoring the serum glucose level is crucial to ensure proper management of the condition. This helps in preventing complications related to blood sugar fluctuations. Assisting the client out of bed may be important but not the primary responsibility at this time. Placing the client in a high-Fowler's position or ensuring the residual limb is elevated are important interventions for comfort and circulation but are not the primary concern in this scenario.

3. What is the softening and thinning of the cervix during labor known as?

• A. Dilation
• B. Symphysis
• C. Effacement
• D. Hyperplasia

Correct answer: C

Rationale: Effacement is the correct term for the softening and thinning of the cervix during labor. It is the process where the cervix becomes thinner, allowing it to stretch and open as labor progresses. Choice A, 'Dilation,' is incorrect as it refers to the opening of the cervix. Choice B, 'Symphysis,' is incorrect as it refers to the joint that connects the two pubic bones. Choice D, 'Hyperplasia,' is incorrect as it refers to an increase in the number of cells in an organ or tissue.

4. Although there is projected to be a small surplus of nurses by 2030, some states will continue to see nursing shortages. Which of the following is the best explanation for this situation?

• A. Healthcare legislation that impacts nursing salaries in some states
• B. Workforce availability
• C. Aging of the baby boomers, resulting in a younger nursing workforce
• D. Population declines

Correct answer: B

Rationale: The best explanation for the continued nursing shortages in some states despite an overall projected surplus by 2030 is workforce availability. This factor directly impacts the number of nurses available in certain regions. Choice A about healthcare legislation affecting nursing salaries does not directly address the availability of nurses. Choice C is incorrect as the aging of the baby boomers would typically imply an older nursing workforce instead of a younger one. Choice D regarding population declines does not necessarily relate to the availability of nurses in specific states.

5. A healthcare provider is caring for a client who has anorexia nervosa. Which of the following interdisciplinary team members should be consulted in regards to client care?

• A. Occupational therapist
• B. Case manager
• C. Nutritionist
• D. Psychiatrist

Correct answer: B

Rationale: A case manager is the most appropriate interdisciplinary team member to consult for a client with anorexia nervosa. They can help coordinate care, resources, and communication between various healthcare professionals involved in the client's treatment. Consulting an occupational therapist (Choice A) may not directly address the primary concerns associated with anorexia nervosa. While nutritional therapists (Choice C) play a role in addressing nutritional needs, a case manager is better suited for overall care coordination. Mental health counselors (Choice D) focus more on emotional and psychological aspects, whereas a case manager coordinates practical aspects of care.

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