Nursing Elites

1. A client with DM states, 'I cannot eat big meals; I prefer to snack throughout the day.' The nurse should carefully explain that the:

• A. Regulated food intake is crucial for control
• B. Restricting salt and sugar is the main concern
• C. Opting for small, frequent meals aids digestion
• D. Consuming large meals can contribute to weight issues

Correct answer: A

Rationale: In clients with diabetes, regulated food intake is crucial for controlling blood glucose levels. Choice A is the correct answer because maintaining consistent meal sizes and timings helps in managing blood sugar levels effectively. Choice B is incorrect because while monitoring salt and sugar intake is important, it is not the primary consideration in this scenario. Choice C is incorrect as the focus is on regulating food intake rather than aiding digestion. Choice D is also incorrect because consuming large meals can indeed lead to fluctuations in blood glucose levels, but the primary concern in this case is the regulation of food intake for better control of diabetes.

2. A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?

• A. A client who is at 32 weeks of gestation and has premature rupture of membranes
• B. A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor
• C. A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump
• D. A client who has gestational diabetes and is receiving biweekly nonstress tests

Correct answer: C

Rationale: A nurse who floated from a medical-surgical unit would be appropriate to care for a client who is 1 day postoperative following a Cesarean section and has a PCA pump. This client requires monitoring of the postoperative incision site, pain management through the PCA pump, and assessment for any signs of complications related to the surgery. Assigning this client to an RN with experience in postoperative care aligns with providing specialized and appropriate care. Choices A, B, and D involve conditions or procedures specific to obstetrics that would be better managed by a nurse with obstetrical experience, making them incorrect choices for the floated RN.

3. What is the purpose of a healthcare audit?

• A. To increase paperwork
• B. To assess and improve quality of care
• C. To reduce patient satisfaction
• D. To limit healthcare services

Correct answer: B

Rationale: The correct answer is B: 'To assess and improve quality of care.' Healthcare audits are conducted to evaluate the quality and efficiency of healthcare services provided. Choice A, 'To increase paperwork,' is incorrect as audits aim to streamline processes and reduce unnecessary paperwork. Choice C, 'To reduce patient satisfaction,' is incorrect as audits are meant to identify areas for improvement to enhance patient satisfaction. Choice D, 'To limit healthcare services,' is also incorrect as audits help in optimizing healthcare services rather than limiting them.

4. A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet delivered the oxygen tank. Which of the following actions should the nurse take?

• A. Send an oxygen tank from the facility home with the client
• B. Instruct the client's family to contact the insurance provider about the oxygen equipment
• C. Contact social services about the delivery of the oxygen equipment
• D. Notify the provider about the delayed oxygen tank delivery

Correct answer: C

Rationale: The correct action for the nurse to take is to contact social services about the delivery of the oxygen equipment. This ensures that the necessary equipment is delivered to the client's home promptly. Choice A is incorrect because sending an oxygen tank from the facility is not a sustainable solution and may lead to legal and safety issues. Choice B is incorrect as contacting the insurance provider is not the appropriate course of action to address the delayed delivery. Choice D is also incorrect because notifying the provider about the delay may not directly lead to the timely delivery of the oxygen equipment.

5. A nurse is receiving a verbal prescription from the provider for a client who is experiencing increased pain. The nurse should transcribe which of the following prescriptions in the client's medical record?

• A. Morphine sulfate 10 mg IV q 4 IV prn for pain
• B. MS 10 mg IV every 4 8 prn for pain
• C. MSO4 10 mg IVP q 4 8 prn for pain
• D. Morphine sulfate 10.0 mg every 4 hours IV prn for pain

Correct answer: A

Rationale: The correct transcription is 'Morphine sulfate 10 mg IV q 4 IV prn for pain.' In choice A, 'Morphine sulfate 10 mg IV q 4 IV prn for pain' correctly indicates the medication, route (IV), frequency (every 4 hours), and administration as needed for pain control. Choice B is incorrect as 'MS' is not a standard abbreviation for Morphine Sulfate, and the frequency 'every 4 8' is not a valid time interval. Choice C is incorrect as 'MSO4' is not the standard abbreviation for Morphine Sulfate, and 'IVP' is not the standard route abbreviation for intravenous. Choice D is incorrect as it lacks clarity with '10.0 mg' instead of '10 mg,' and the frequency is given as 'every 4 hours' without specifying the route of administration.

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