Nursing Elites

1. A client with limited mobility in their lower extremities is at risk for skin breakdown. Which of the following actions should the nurse take to prevent skin breakdown?

• A. Place the client in high-Fowler's position.
• B. Increase the client's intake of carbohydrates.
• C. Massage areas of skin that are darker than the surrounding skin tissue with unscented lotion.
• D. Have the client use a trapeze bar when changing position

Correct answer: B

Rationale: The correct answer is B: Increase the client's intake of carbohydrates. Adequate nutrition, including carbohydrates, is essential for tissue repair and preventing skin breakdown. Placing the client in high-Fowler's position (choice A) may help with respiratory function but does not directly prevent skin breakdown. Massaging areas of darker skin (choice C) can cause further damage to the skin. Using a trapeze bar (choice D) may assist with changing positions but does not directly address skin breakdown prevention.

2. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation that should be included in the reminders for ensuring legally credible nursing documentation is to 'Only use approved abbreviations.' Using shortcuts in documentation (Choice A) may lead to incomplete or vague information, compromising the credibility of documentation. Documentation should not be subjective (Choice C) but rather objective and based on factual information. While it is important to document after care is provided (Choice D), the immediate documentation following care provision is critical for accuracy and legal credibility.

3. When a client with a terminal diagnosis asks about advance directives, what should the nurse do?

• A. Engage the client and ask why they want to discuss this without their partner present.
• B. Provide information on advance directives and offer brochures.
• C. Advise the client to schedule a discussion with their provider.
• D. Focus on the client's current feelings and postpone planning for a later time.

Correct answer: A

Rationale: Choice A is the correct response as it demonstrates active listening and empathy by engaging the client in a discussion about their concerns regarding advance directives. It also recognizes the importance of involving the client's partner in such discussions, promoting shared decision-making and support. Choices B and C lack the personalized approach needed in this situation and do not address the client's immediate request for information. Choice D is incorrect as it disregards the client's expressed need to discuss advance directives and focuses solely on their current feelings, delaying a crucial conversation.

4. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

5. What is the primary function of discipline?

• A. To punish
• B. To evaluate
• C. To teach
• D. To ridicule

Correct answer: C

Rationale: The primary function of discipline is to teach individuals appropriate behavior and help them learn from their mistakes. Discipline is meant to guide individuals towards self-improvement and understanding of rules and expectations. Choices A, B, and D are incorrect because discipline is not primarily about punishment, evaluation, or ridicule. While consequences may be a part of discipline, the main goal is to educate and promote positive behavior.

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