Nursing Elites

1. A client being treated for sickle cell disease has an order for pain medication. Morphine was ordered, but the nurse is having difficulty deciphering the dose. The nurse should ____.

• A. ask the attending physician to clarify the order, including the correct medication, dose, route, and frequency
• B. call the charge nurse to inform the attending physician and verify the order, including the correct medication, dose, route, and frequency
• C. call the attending physician to verbally verify the order, including the correct medication, dose, route, and frequency
• D. refrain from administering the medication until the charge nurse can assist in determining the correct dosage

Correct answer: C

Rationale: In this scenario, when a nurse encounters difficulties in deciphering an order, the appropriate action is to contact the attending physician directly to clarify and verify the medication, dose, route, and frequency. It is crucial for the nurse to have a clear understanding of the order before administering any medication to ensure patient safety and proper treatment. Option A is incorrect as it suggests asking the attending physician to clarify without specifying the urgency of the situation. Option B involves an unnecessary additional step by first contacting the charge nurse before reaching out to the attending physician, potentially delaying the clarification process. Option D is incorrect as it advises refraining from administering the medication, which may not be necessary if the correct dosage can be promptly verified by contacting the attending physician.

2. Signs of internal bleeding include all of the following except:

• A. painful or swollen extremities
• B. a tender, rigid abdomen
• C. vomiting bile
• D. bruising

Correct answer: C

Rationale: Vomiting bile is not typically a sign of internal bleeding but is more commonly associated with issues in the gastrointestinal tract. Signs of internal bleeding include painful or swollen extremities, a tender, rigid abdomen, and bruising. Painful or swollen extremities can indicate bleeding from an extremity injury, a tender, rigid abdomen can signal abdominal bleeding, and bruising can result from blood vessel damage. Therefore, the correct answer is 'C: vomiting bile,' as it is not a typical sign of internal bleeding.

3. A client expresses anxiety about having magnetic resonance imaging performed. Which of the following is an appropriate response by the nurse?

• A. "You can receive a sedative to help you relax during the test."?
• B. "There is absolutely nothing to worry about."?
• C. "There is no discomfort with this test, so don't be anxious."?
• D. "The test won't last long, so you can handle it."?

Correct answer: A

Rationale: The correct response acknowledges the client's anxiety and offers a practical solution to alleviate it, showing empathy and addressing the client's concerns. Offering a sedative to help relax during the test is a proactive approach to managing the client's anxiety. Choices B and C dismiss the client's feelings by invalidating their anxiety, which can further escalate their distress. Choice D downplays the client's feelings by implying they should not be worried, which does not effectively address the client's emotional state.

4. The healthcare provider is using Cognitive-Behavioral methods of pain control and knows that these methods can be expected to do all the following except:

• A. completely relieve all pain.
• B. provide benefit by restoring the client's sense of self-control.
• C. help the client to control symptoms.
• D. help the client actively participate in his or her care.

Correct answer: A

Rationale: Cognitive-Behavioral methods of pain control aim to provide benefit by restoring the client's sense of self-control, helping the client to control symptoms, and encouraging the client to actively participate in their care. However, these methods are not intended to completely relieve all pain. These interventions focus on perception and thought, aiming to influence how one interprets events and bodily sensations. Therefore, the correct answer is that they cannot completely relieve all pain, as pain relief is often a multifaceted approach that may require additional interventions beyond Cognitive-Behavioral methods. Choices B, C, and D are correct as Cognitive-Behavioral methods are designed to empower the individual in managing their pain and improving their overall well-being.

5. What can happen if a restraint is attached to a side rail or other movable part of the bed?

• A. Do nothing to the client.
• B. Injure the client if the rail or bed is moved.
• C. Help the client stay in the bed without falling out.
• D. Help the client with better posture.

Correct answer: B

Rationale: Attaching a restraint to a movable part of the bed can lead to client injury if that part of the bed is moved before releasing restraints. This could result in the client getting caught or trapped, possibly causing harm. Choices C and D are incorrect because attaching restraints to movable parts of the bed is not intended to help the client stay in bed or improve posture; rather, it poses a risk of injury. Choice A is incorrect as it does not address the potential harm associated with using restraints on movable parts of the bed.

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