Nursing Elites

1. A nurse is assisting a new nursing graduate with organizational skills in delivering client care. The nurse determines that the new nursing graduate needs assistance with time management if the new graduate takes which action?

• A. Gathers supplies before beginning a task
• B. Allows time for unexpected tasks
• C. Prioritizes client needs and daily tasks
• D. Documents task completion and client information at the end of the day

Correct answer: A

Rationale: The correct answer is 'Gathers supplies before beginning a task.' This action indicates a lack of effective time management because gathering supplies before starting a task can lead to inefficiency and time wastage. Effective time management involves organizing tasks efficiently, which includes having all necessary supplies ready before initiating a task. Allowing time for unexpected tasks, prioritizing client needs and daily tasks, and documenting task completion and client information at the end of the day are all essential components of good time management practices. Therefore, the new nursing graduate should focus on improving the timing of supply gathering to enhance time management skills. The other choices are not indicative of poor time management; instead, they demonstrate important aspects of effective time management in client care delivery.

2. A 51-year-old client with amyotrophic lateral sclerosis (Lou Gehrig disease) is admitted to the hospital because his condition is deteriorating. The client tells the nurse that he wants a do-not-resuscitate (DNR) order. The nurse should provide the client with which information?

• A. Oral consent is not sufficient, and the client's request will be honored by all healthcare providers.
• B. Consent must be obtained from the family.
• C. The DNR request should be discussed with the healthcare provider, who will write the order.
• D. The healthcare provider makes the final decision about a DNR request.

Correct answer: C

Rationale: When a client requests a DNR order, the nurse should contact the healthcare provider so that the provider may discuss the request with the client. A DNR order should be written, not verbal, following agency and state guidelines. Therefore, the correct answer is that the DNR request should be discussed with the healthcare provider, who will write the order. Option A is incorrect as oral consent is not sufficient for a DNR order. Option B is incorrect because the client, not the family, has the authority to request a DNR order. Option D is incorrect because the healthcare provider discusses the request with the client but does not make the final decision.

3. A case manager is serving on a community task force on violence in schools. The members of the task force are planning to develop interventions to help prevent violence. According to the nursing process, which is the first activity that the case manager would suggest to the task force?

• A. Teaching schoolchildren about the dangers of school violence
• B. Conducting a community survey to assess community perceptions regarding school violence
• C. Looking at what other communities are doing about school violence
• D. Distributing flyers that identify the causes of school violence to families in the community

Correct answer: B

Rationale: The correct answer is to conduct a community survey to assess community perceptions regarding school violence. In the nursing process, assessment is always the first step. By conducting a survey, the task force can gather important data about how the community perceives school violence, which is essential for developing effective interventions. Choices A, C, and D involve actions that come after the assessment phase. Teaching schoolchildren about the dangers of violence and distributing flyers are important activities but should come after understanding the community's perceptions and needs. Looking at what other communities are doing is valuable but should also follow a thorough assessment of the specific community's needs and perceptions.

4. The nurse receives an assignment of three clients. Which of the following should the nurse consider as the highest priority when determining which client to assess first?

• A. the client who most recently rang their call bell
• B. the client who has been waiting the longest for their call bell to be answered
• C. the client who is in the most pain
• D. the client who may have a risk for an airway obstruction

Correct answer: D

Rationale: The nurse should prioritize assessing a client with a potential airway obstruction first based on the ABCs (airway, breathing, circulation) principle. Maintaining a clear airway is crucial for oxygenation and ventilation, making it the highest priority. Choices A and B focus on call bells and waiting times, which are important but not life-threatening in comparison to airway concerns. While pain management is essential, it takes precedence after addressing immediate life-threatening issues like airway compromise.

5. Which of the following ethnic groups is at highest risk in the United States for pesticide-related injuries?

• A. Native American
• B. Asian-Pacific
• C. Norwegian
• D. Hispanic

Correct answer: D

Rationale: Hispanic people are at the highest risk in the United States for pesticide-related injuries due to their significant representation among migrant workers in agricultural settings. Working in such environments exposes them to pesticides more frequently, thus elevating their risk compared to other ethnic groups. In contrast, Native American, Asian-Pacific, and Norwegian populations are not as commonly engaged in agricultural work involving pesticide exposure, which makes them less susceptible to pesticide-related injuries. Therefore, the correct answer is Hispanic.

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