Nursing Elites

1. A nurse is caring for a client who is postoperative following surgical repair of a mandibular fracture with fixed occlusion of the jaws in a closed position. Which of the following statements is the priority for the nurse to make?

• A. "We can teach you some relaxation techniques to minimize your pain."
• B. "Keep wire cutters with you at all times."
• C. "Use a water pick device to keep your teeth clean."
• D. "Consume a high-protein, liquid diet."

Correct answer: B

Rationale:

2. A nurse is caring for a client post-myocardial infarction (MI). What is the priority assessment for this client?

• A. Monitoring urine output
• B. Checking blood glucose levels
• C. Assessing for chest pain
• D. Monitoring electrolyte levels

Correct answer: C

Rationale: Assessing for chest pain is crucial in post-MI clients as it can indicate complications such as reinfarction or ischemia.

3. How can a nurse manager best improve hand-off communication among the staff? (SATA)

• A. Attending hand-off rounds to coach and mentor.
• B. Conducting audits of staff using a new template.
• C. Creating a template of topics to include in the report.
• D. Utilizing the SHARE model as a tool for standardizing hand-off reports and other critical communication.

Correct answer: D

Rationale: The SHARE model is a valuable tool for standardizing hand-off reports and other critical communication. By utilizing this model, the nurse manager can ensure consistency and clarity in hand-off communication among the staff. While attending hand-off rounds to coach and mentor, conducting audits using a new template, and creating a template of topics to include in the report can all be beneficial actions, the most effective approach to achieve the goal of improving hand-off communication is by implementing a standardized tool like the SHARE model.

4. A nurse collaborates with a respiratory therapist to complete pulmonary function tests (PFTs) for a client. Which statements should the nurse include in communications with the respiratory therapist prior to the tests? (SATA)

• A. I held the client's morning bronchodilator medication.
• B. The client is ready to go down to radiology for this examination.
• C. Physical therapy states the client can run on a treadmill.
• D. I advised the client not to smoke for 6 hours prior to the test.

Correct answer: B

Rationale: To ensure the PFTs are accurate, the therapist needs to know that no bronchodilators have been administered in the past 4 to 6 hours, the client did not smoke within 6 to 8 hours prior to the test and the client can follow basic commands, including different breathing maneuvers. The respiratory therapist can perform PFTs at the bedside. A treadmill is not used for this test.

5. A client has a new diagnosis of myasthenia gravis. For which of the following manifestations should the nurse monitor?

• A. Confusion
• B. Weakness
• C. Increased intracranial pressure
• D. Increased urinary output

Correct answer: B

Rationale: In myasthenia gravis, a neuromuscular disorder characterized by muscle weakness and fatigue, weakness is a common manifestation due to the immune system attacking the communication between nerves and muscles. Monitoring for weakness is crucial to assess the disease progression and determine the effectiveness of treatment. Confusion is not a typical manifestation of myasthenia gravis. Increased intracranial pressure and increased urinary output are not directly associated with this condition.

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