Nursing Elites

1. A healthcare professional is caring for a client who has a sodium level of 125 mEq/L (136 to 145 mEq/L). Which of the following findings should the healthcare professional expect?

• A. Positive Chvostek's sign
• B. Bradycardia
• C. Numbness of the extremities
• D. Abdominal cramping

Correct answer: D

Rationale: A sodium level of 125 mEq/L indicates hyponatremia, which can lead to abdominal cramping. Abdominal cramping is a common symptom of hyponatremia due to an imbalance in electrolytes. While other options like Chvostek's sign, bradycardia, and numbness of the extremities can be associated with other electrolyte imbalances, they are not typically seen with low sodium levels. Chvostek's sign is related to hypocalcemia, bradycardia can be seen in hyperkalemia, and numbness of the extremities can be a symptom of hypocalcemia or hypokalemia, but not directly related to hyponatremia.

2. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?

• A. Carefully assess and document client status.
• B. Ensure all patient information is logged out and the nurse has signed out of the computer before leaving the computer station.
• C. Keep careful notes while providing care to ensure accurate documentation later in the day.
• D. Discuss safety needs with clients.

Correct answer: A

Rationale: The correct answer is A: Carefully assess and document client status. By carefully assessing and documenting the client's status, healthcare providers can ensure they have a clear understanding of the client's condition, needs, and any potential risks. This helps in providing appropriate care and avoiding situations that may lead to charges of negligence or false imprisonment. Choice B is incorrect because logging out of computer systems is more related to data security and confidentiality rather than preventing negligence or false imprisonment. Choice C is not directly related to avoiding charges of negligence and false imprisonment but rather ensuring accurate documentation. Choice D, while important for overall client safety, does not specifically address the issue of avoiding charges of negligence and false imprisonment for confused clients.

3. A nurse has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?

• A. The client reports relief of nausea.
• B. The tube aspirate has a pH less than 5.
• C. Bowel sounds are present on auscultation.
• D. An x-ray shows the end of the tube above the pylorus.

Correct answer: A

Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.

4. What is the main purpose of a patient satisfaction survey?

• A. To improve patient outcomes
• B. To evaluate nursing performance
• C. To measure patient satisfaction
• D. To assess healthcare facilities

Correct answer: C

Rationale: The main purpose of a patient satisfaction survey is to measure patient satisfaction. These surveys aim to gather feedback directly from patients regarding their experiences and perceptions of the healthcare services they have received. While patient satisfaction may impact outcomes indirectly, the primary goal of the survey is not to directly improve patient outcomes, making choice A incorrect. Choice B is incorrect because patient satisfaction surveys are not primarily focused on evaluating nursing performance specifically. Choice D is also incorrect because the main focus of the survey is on the satisfaction of patients rather than assessing healthcare facilities.

5. A nurse is discussing the responsibility of caring for clients with clostridium difficile infection. Which of the following information should the nurse include in the teaching?

• A. Have family members wear a gown and gloves when visiting.
• B. Clean contaminated surfaces in the client's room with a bleach solution.
• C. Use alcohol-based hand sanitizer when leaving the client's room.
• D. Assign the client to a room with a private bathroom.

Correct answer: A

Rationale: When caring for clients with clostridium difficile infection, it is important to prevent the spread of the bacteria. Having family members wear a gown and gloves when visiting helps reduce the risk of transmission. Cleaning contaminated surfaces with a bleach solution, not phenol, is recommended to effectively kill the C. difficile spores. Using alcohol-based hand sanitizer is not sufficient, as it may not be effective against C. difficile spores. Assigning the client to a room with a private bathroom is more beneficial than a negative airflow system, as it helps prevent the spread of bacteria to other clients.

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