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 nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?

• A. Wear an N95 respirator when giving direct care to the client.
• B. Place the client in a private room with negative-pressure airflow.
• C. Ensure the client's room has at least six air exchanges per hour.
• D. Ensure the client wears a mask when outside their room if there is construction in the area.

Correct answer: A

Rationale: In a protective environment for a client with an allogeneic stem cell transplant, the nurse needs to wear an N95 respirator when providing direct care to the client. This precaution is essential to protect the client, whose immune system is compromised after the transplant, from exposure to potential pathogens. Placing the client in a private room with negative-pressure airflow (choice B) is more appropriate for clients with airborne infections. Ensuring the client's room has sufficient air exchanges (choice C) is important for maintaining air quality but is not the primary precaution for protecting an immunocompromised client. Making the client wear a mask when outside the room due to construction (choice D) focuses on external factors and does not directly address the risk of infection during direct care.

3. A nurse supervisor is planning an educational session for her staff regarding improving teamwork among different generations. Which of the following recommendations will reduce potential generational conflicts?

• A. Involve only millennials in technology decisions.
• B. Focus on the team as a whole, rather than individual generations.
• C. Involve only the baby boomers in technology decisions.
• D. Practice active and assertive communication techniques.

Correct answer: D

Rationale: Active and assertive communication will assist each generation to value the others� skills and perspectives.

4. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: A DNR order can be written after the health-care provider has discussed it with the client and family.

5. A nurse manager is considering the variances of the budget. Fewer monies were spent than expected. What type of variance is this?

• A. Unfavorable variance
• B. Favorable variance
• C. Dependent variance
• D. Independent variance

Correct answer: B

Rationale: The correct answer is B, favorable variance. When fewer funds are spent than expected, it indicates efficient budget management, making it a favorable outcome. Choice A, unfavorable variance, is incorrect as it would apply if more money than expected was spent. Choices C and D, dependent variance and independent variance, are unrelated terms in the context of budget variances and do not apply to the situation described.

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