Nursing Elites

1. A nurse is caring for a client who is postoperative. When the nurse prepares to change the client's dressing, they say, 'Every time you change my bandage, it hurts so much.' Which of the following interventions is the nurse's priority action?

• A. Encourage the client to relax and take deep breaths during the dressing change
• B. Educate the client about the importance of the dressing change to prevent infection
• C. Administer pain medication 45 minutes before changing the client's dressing
• D. Assist the client to a comfortable position for the dressing change

Correct answer: C

Rationale: The correct answer is to administer pain medication 45 minutes before changing the client's dressing. This intervention is the priority action because the client is experiencing pain during the dressing change. Providing pain relief beforehand can help minimize the discomfort and improve the overall experience for the client. Encouraging relaxation techniques (choice A) or educating about dressing change importance (choice B) are valuable but addressing pain is the priority. Assisting the client to a comfortable position (choice D) is essential for the procedure but does not directly address the client's pain.

2. When is the first opportunity for a manager to reduce turnover?

• A. When the decision to hire a new employee is made
• B. After one month of employment
• C. After three months of employment
• D. After a certain tenure period

Correct answer: C

Rationale: The manager's first opportunity to reduce turnover occurs after three months of employment. During this period, the manager can assess the employee's performance, engagement, and fit within the organization. It allows the manager to address any concerns, provide support, and intervene early to prevent turnover. Waiting until after a certain tenure period might be too late to effectively mitigate turnover risk, as issues could have already escalated. Therefore, the three-month mark is a critical point for managers to proactively manage turnover. Choices A and B are incorrect because they do not allow sufficient time for the manager to evaluate the employee and take proactive measures to reduce turnover. Choice D is incorrect as it is too vague and does not provide a specific actionable timeframe for addressing turnover concerns.

3. When facing problems that require immediate action, what organized method involving seven specific steps can nurses use for effective problem-solving?

• A. Nominal group technique
• B. Delphi method
• C. Problem-solving process
• D. Brainstorming

Correct answer: C

Rationale: The correct answer is C: Problem-solving process. The problem-solving process involving seven specific steps is a structured approach that nurses can utilize when immediate action is required. This method allows for a systematic and organized way of addressing urgent issues, ensuring a thorough and effective problem-solving approach. Choices A, B, and D are incorrect because they do not specifically refer to the structured method involving seven specific steps that nurses can follow for effective problem-solving.

4. The staff nurse is experiencing what type of conflict when the babysitter calls to cancel on the day of an important committee meeting?

• A. Intergroup conflict
• B. Perceived conflict
• C. Role conflict
• D. Structural conflict

Correct answer: C

Rationale: The correct answer is C: Role conflict. Role conflict arises when one has conflicting responsibilities or obligations, such as being scheduled to work while also needing to care for children. In this scenario, the staff nurse faces a conflict between their role as a parent needing childcare and their role as a professional scheduled to present at a committee meeting. Intergroup conflict (A) involves disputes between different groups, not conflicting roles within an individual. Structural conflict (D) stems from issues within the organizational structure, not conflicting responsibilities. Perceived conflict (B) refers to misunderstandings or misinterpretations between parties, not conflicting roles.

5. A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to

• A. check glucose levels before, during, and after swimming.
• B. delay eating the noon meal until after swimming.
• C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
• D. time the morning insulin injection so that the peak occurs while swimming.

Correct answer: A

Rationale: The correct answer is to teach the patient to check glucose levels before, during, and after swimming. This is important to monitor blood sugar levels and make adjustments as needed to prevent hypoglycemia or hyperglycemia. Delaying eating the noon meal until after swimming (Choice B) is not advisable as the patient needs proper nutrition both before and after exercise. Increasing the morning dose of NPH insulin (Choice C) should not be done without proper medical advice as it can lead to hypoglycemia. Timing the morning insulin injection to coincide with swimming (Choice D) is risky as the peak effect of insulin may lead to hypoglycemia during swimming.

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