Nursing Elites

1. A nurse in an emergency department is preparing a change-of-shift report for an adult client who is transferring to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the report?

• A. The client has a do-not-resuscitate order.
• B. The client has a continuous IV of lactated Ringer's.
• C. The client was straight catheterized for 350 mL 2 hours ago.
• D. The client has Medicare insurance.

Correct answer: A

Rationale: In an SBAR report, key information such as the client's do-not-resuscitate (DNR) status should be included as it directly impacts the client's care and treatment plan. Choices B and C are important details but may not be as critical for immediate care planning during the shift change. Choice D, the client having Medicare insurance, is important for billing purposes but does not directly impact the client's immediate care needs.

2. A nurse is observing a patient's use of a walker. Which observation indicates a need for further teaching?

• A. The patient advances the walker too far ahead.
• B. The patient uses the walker to assist in standing.
• C. The patient maintains their balance while using the walker.
• D. The patient walks with their back hunched over.

Correct answer: A

Rationale: The correct answer is A because advancing the walker too far ahead increases the risk of falls, indicating a need for further teaching. Choice B is correct as using the walker to assist in standing is a proper use. Choice C is correct as maintaining balance while using the walker shows proper technique. Choice D is incorrect as walking with the back hunched over is a posture issue, not directly related to walker use.

3. A nurse is caring for a client who has an ethical conflict about the care she is receiving. Which of the following resources should the nurse consult about resolving the dilemma?

• A. Hospital ethics committee
• B. Quality improvement committee
• C. Chaplain
• D. Director of nursing

Correct answer: A

Rationale: The correct answer is the hospital ethics committee. This committee is specifically designed to address and resolve ethical conflicts in patient care. It comprises professionals from various disciplines who can provide guidance and support in navigating ethical dilemmas. Choice B, the quality improvement committee, focuses on enhancing the quality of care provided but may not be equipped to handle ethical conflicts. Choice C, the chaplain, offers spiritual and emotional support but may not have the expertise to resolve ethical dilemmas. Choice D, the director of nursing, is responsible for nursing operations and may not be the appropriate resource for addressing ethical conflicts.

4. Which factor places a patient at the highest risk for infection?

• A. A healthy immune system
• B. Presence of chronic illness
• C. Being well-nourished
• D. Age over 65 years

Correct answer: B

Rationale: The presence of chronic illness is the factor that places a patient at the highest risk for infection. Chronic illness can compromise the immune system's ability to fight off infections effectively, making individuals more susceptible to getting sick. Option A, a healthy immune system, actually reduces the risk of infection. Option C, being well-nourished, can support overall health but does not directly correlate with infection risk. While age over 65 years is a risk factor for certain infections due to age-related immune system changes, chronic illness has a more significant impact on infection risk.

5. A client with a history of falls is under the care of a nurse. Which intervention is most important to implement?

• A. Increase the frequency of bed checks.
• B. Use bed alarms to prevent falls.
• C. Keep the room well lit during the day.
• D. Encourage the client to use a walker for mobility.

Correct answer: B

Rationale: Using bed alarms to prevent falls is the most important intervention to implement for a client with a history of falls. Bed alarms can provide timely alerts to the healthcare team, allowing for quick assistance to prevent falls. Increasing the frequency of bed checks may not necessarily prevent falls as effectively as direct intervention with bed alarms. Keeping the room well lit is important for general safety but may not address the immediate risk of falls. Encouraging the client to use a walker for mobility is beneficial but may not be as crucial as implementing bed alarms to prevent falls in this scenario.

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