Nursing Elites

1. A nurse discovers a discrepancy in the narcotics log. What is the appropriate next step?

• A. Correct the log and notify the pharmacy.
• B. Report the discrepancy to the nurse manager.
• C. Re-administer the narcotic.
• D. Dispose of the narcotic and note the discrepancy.

Correct answer: B

Rationale: When a nurse discovers a discrepancy in the narcotics log, the appropriate next step is to report the discrepancy to the nurse manager. This is important to ensure that the issue is properly investigated and addressed. Choice A is incorrect because simply correcting the log and notifying the pharmacy may not address the root cause of the discrepancy. Choice C is incorrect as re-administering the narcotic without clarification could lead to potential harm or legal issues. Choice D is incorrect as disposing of the narcotic without following proper protocols and documentation could result in further complications.

2. What are the important considerations when administering blood products to a patient?

• A. Ensuring proper documentation of the transfusion
• B. Verifying the patient's identity before administration
• C. Monitoring for allergic reactions or transfusion reactions
• D. Monitoring the patient's vital signs during transfusion

Correct answer: B

Rationale: Verifying the patient's identity before administration is a critical step to ensure that the correct blood product is given to the right patient, thereby preventing transfusion errors. While ensuring proper documentation of the transfusion (choice A) is important for record-keeping, verifying patient identity (choice B) directly addresses the risk of administering blood to the wrong patient. Monitoring for allergic reactions or transfusion reactions (choice C) and monitoring the patient's vital signs during transfusion (choice D) are also essential considerations during blood product administration, but verifying patient identity takes precedence to prevent potentially life-threatening errors.

3. When preparing to give a report during a shift change, what information is most critical to communicate?

• A. Include a full family medical history.
• B. Focus on changes in the patient's condition.
• C. Summarize the patient's treatment plan.
• D. Provide updates on the patient's lab results.

Correct answer: B

Rationale: During a shift change report, the most critical information to communicate is focusing on changes in the patient's condition. This helps ensure that all healthcare providers are aware of any significant developments or deterioration in the patient's health status, allowing for timely and appropriate interventions. Choices A, C, and D are not as crucial during a shift report. While a full family medical history and treatment plan are important aspects of patient care, they are not the primary focus during a shift change report. Providing updates on lab results may be important but may not be as time-sensitive or immediately impactful as changes in the patient's condition.

4. A nurse is preparing to administer enoxaparin subcutaneously to a client. Which of the following actions should the nurse take?

• A. Inject at a 90-degree angle
• B. Inject at a 45-degree angle
• C. Massage the injection site after administering
• D. Use a longer needle

Correct answer: B

Rationale: The correct answer is to inject enoxaparin subcutaneously at a 45-degree angle. This angle helps ensure proper delivery of the medication into the subcutaneous tissue. Option A (Inject at a 90-degree angle) is incorrect because subcutaneous injections are usually given at a shallower angle. Option C (Massage the injection site after administering) is incorrect as massaging the site can cause bruising and should generally be avoided. Option D (Use a longer needle) is incorrect as using a longer needle is unnecessary and may increase the risk of injecting the medication too deeply.

5. A charge nurse on a medical-surgical unit is preparing to delegate tasks to a licensed practical nurse (LPN). Which of the following tasks should the charge nurse delegate to the LPN?

• A. Administering an oral antibiotic to a client
• B. Performing an admission assessment of a client
• C. Creating new teaching for a guardian of a toddler
• D. Administering IV conscious sedation to a client

Correct answer: A

Rationale: Administering oral antibiotics is within the scope of practice for an LPN and can be safely delegated. LPNs are trained to administer medications, including oral ones. Performing an admission assessment (Choice B) involves critical thinking and comprehensive evaluation, typically done by registered nurses. Creating new teaching material (Choice C) requires specialized knowledge and is usually the responsibility of a nurse with additional training in education. Administering IV conscious sedation (Choice D) is a high-risk task that requires advanced skills and should be performed by a registered nurse or higher-level provider.

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