Nursing Elites

1. A nurse is assessing a client who is postoperative following a left leg below-the-knee amputation. Which of the following client statements indicates the potential need for a referral to an occupational therapist?

• A. I hope I can adjust to using crutches while I am recovering.
• B. I am worried about taking care of my toddler at home.
• C. I just don't think I can handle looking at my leg.
• D. I am not sure how I will pay for all the therapy I will need.

Correct answer: A

Rationale: The client's statement about adjusting to using crutches while recovering suggests a potential need for occupational therapy referral. Occupational therapists assist individuals in regaining independence in activities of daily living, including mobility aids and adaptations. Choices B, C, and D are more indicative of emotional or financial concerns and may require referrals to other healthcare professionals like counselors or financial advisors, rather than occupational therapists.

2. To resolve a conflict between staff members regarding potential changes in policy, a nurse manager decides to implement the changes she prefers regardless of the feelings of those who oppose those changes. Which of the following conflict-resolution strategies is the nurse manager using?

• A. Competing
• B. Collaborating
• C. Compromising
• D. Cooperating

Correct answer: A

Rationale: The nurse manager is utilizing the competing conflict-resolution strategy. Competing involves making decisions based on one's preferences without considering the opinions or feelings of others. In this scenario, the nurse manager is unilaterally implementing changes despite opposition, demonstrating a competitive approach. Collaborating involves working together to find a mutually beneficial solution, compromising involves finding a middle ground acceptable to both parties, and cooperating involves working together towards a shared goal. These options are not applicable in this situation as the nurse manager is imposing her preferred changes without regard for others' input.

3. The nurse is planning care for a patient with acute hypernatremia. What should the nurse include in this patient's plan of care? (select one that does not apply)

• A. Reduce IV access
• B. Limit length of visits
• C. Restrict fluids to 1500 mL per day
• D. Conduct frequent neurologic checks

Correct answer: D

Rationale: For a patient with acute hypernatremia, the nurse should include interventions like reducing free water losses, correcting sodium levels slowly, monitoring neurologic status, and ensuring adequate fluid intake. Conducting frequent neurologic checks is essential in assessing the patient's neurological status and detecting any changes promptly. Therefore, this action should not be excluded from the plan of care. Choices A, B, and C are not directly related to managing acute hypernatremia and can be safely excluded from the plan of care. Reducing IV access, limiting length of visits, and restricting fluids to 1500 mL per day are not appropriate actions for managing acute hypernatremia.

4. Insulin forces which of the following electrolytes out of the plasma and into the cells?

• A. Calcium
• B. Magnesium
• C. Phosphorus
• D. Potassium

Correct answer: D

Rationale: Insulin forces potassium out of the plasma and into the cells, which can cause hypokalemia. This is because insulin enhances the activity of the sodium-potassium pump in cell membranes, promoting the movement of potassium from the extracellular fluid into the cells. Choices A, B, and C are incorrect as insulin does not directly influence the movement of calcium, magnesium, or phosphorus in the same manner as it does with potassium.

5. Serge, who has diabetes mellitus, is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of action for the nurse regarding Serge's oral medications?

• A. Administer the oral agents immediately after the test.
• B. Notify the diagnostic department and request orders.
• C. Notify the physician and request orders.
• D. Administer the oral agents with a sip of water before the test.

Correct answer: C

Rationale: The best plan of action for the nurse is to notify the physician and request orders regarding Serge's oral medications. By involving the physician, the nurse ensures that appropriate instructions are obtained, considering Serge's medical condition and the need for NPO status for the diagnostic test. Administering the medications without medical guidance (choice A) can be risky, as it may affect the test results. Notifying the diagnostic department (choice B) is not the most direct and appropriate action; the physician is the primary healthcare provider responsible for medication orders. Administering the medications with water before the test (choice D) is not advisable when the patient is supposed to be NPO, as it can interfere with the test requirements.

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