Nursing Elites

1. A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following statements should the nurse identify as an indication that the client understands the preoperative teaching they received about pain management?

• A. ''I think I should take my pain medication more often, since it is not controlling my pain.''
• B. ''Breathing faster will help me keep my mind off of the pain.''
• C. ''It might help me to listen to music while I'm lying in bed.''
• D. ''I don't want to walk today because I have some pain.''

Correct answer: D

Rationale: The correct answer is D because the client is demonstrating an understanding of the preoperative teaching by acknowledging the pain and relating it to the need to rest. Walking may exacerbate the pain, and the client's decision not to walk shows an awareness of their body's signals. Choices A, B, and C are incorrect as they do not reflect a good understanding of pain management. Choice A suggests self-medicating without consulting healthcare providers, choice B focuses on distraction rather than addressing the pain, and choice C offers a coping mechanism but does not address the pain directly.

2. A client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?

• A. Continuous quality improvement
• B. Total quality management
• C. Six Sigma
• D. Quality management

Correct answer: B

Rationale: Total Quality Management (TQM) emphasizes meeting customer needs and satisfaction. In this scenario, by honoring the client's request to delay care to allow for rest, the nurse is aligning with the customer-focused approach of TQM. TQM seeks to continuously improve processes and services to enhance customer experiences and outcomes. Continuous Quality Improvement focuses on incremental improvements in processes and outcomes over time. Six Sigma is a data-driven approach to process improvement that aims to reduce defects and errors. Quality Management is a broader concept that encompasses various strategies to ensure quality standards are met.

3. A healthcare professional is preparing to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the healthcare professional delegate?

• A. Confirming that a client's pain has decreased after receiving an analgesic
• B. Ambulating a client who is postoperative
• C. Inserting an indwelling urinary catheter for a client
• D. Demonstrating the use of an incentive spirometer to a client

Correct answer: A

Rationale: The correct answer is option A: 'Confirming that a client's pain has decreased after receiving an analgesic.' This task involves assessing the effectiveness of the medication, which can be delegated to the assistive personnel. Options B, C, and D involve skills that should be performed by licensed healthcare professionals due to their complexity and potential risks if not done correctly. Ambulating a postoperative client requires monitoring for signs of distress or complications, inserting a urinary catheter involves an invasive procedure with infection risks, and demonstrating the use of medical devices like an incentive spirometer requires specialized knowledge to ensure correct usage.

4. Which of the following are effective strategies to become more resilient? (EXCEPT)

• A. Exercising and avoiding high-fat foods.
• B. Managing time effectively.
• C. Becoming more self-aware.
• D. Deciding that your career is not your highest priority.

Correct answer: D

Rationale: Resilience can be enhanced through various strategies such as exercising, managing time effectively, and becoming more self-aware. Deciding that your career is not your highest priority may not necessarily contribute to building resilience as it does not directly address the personal traits and coping mechanisms associated with resilience. This choice focuses more on prioritization rather than the specific skills and mindset needed to bounce back from challenges. Sherman's study (2004) highlighted the importance of self-awareness in preventing burnout among nurses, emphasizing the value of self-care and personal well-being in maintaining resilience.

5. What is the primary focus of transitional care?

• A. To improve clinical outcomes
• B. To manage chronic diseases
• C. To facilitate smooth transitions between care settings
• D. To support family caregivers

Correct answer: C

Rationale: The primary focus of transitional care is to facilitate smooth transitions between care settings. While improving clinical outcomes and managing chronic diseases are important aspects of healthcare, the main goal of transitional care is to ensure patients move smoothly between different care settings such as hospitals, rehabilitation centers, and home care. Supporting family caregivers is also essential but not the primary focus of transitional care.

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