Nursing Elites

1. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

2. Attending a continuing education class on advanced technology in health care is interpreted as which of the following by the nurse manager?

• A. Only important for nurse managers
• B. Not important
• C. A waste of time
• D. Essential to nursing care

Correct answer: D

Rationale: The correct answer is D: 'Essential to nursing care.' Advancements in technology play a crucial role in modern healthcare delivery. By attending a class on advanced technology, the staff nurse can enhance their skills and knowledge, ultimately benefiting nursing care. Choices A, B, and C are incorrect because advanced technology is not exclusive to nurse managers, is important for improving patient care, and is not a waste of time as it helps nurses stay updated with the latest advancements.

3. The staff in the emergency department has presented the nurse leader with a suggestion for streamlining the triage process, cutting down on wait times. Which of the following qualities does the leader specifically need to implement the suggestion?

• A. Courage
• B. Integrity
• C. Energy
• D. Initiative

Correct answer: D

Rationale: Initiative is the correct quality needed in this situation. The staff has provided a suggestion for improvement, and the leader must take the initiative to implement it. Courage, integrity, and energy are valuable qualities as well but in this context, the most essential quality is initiative to drive the change forward and improve the triage process efficiently.

4. Which action by a patient indicates that the home health nurse’s teaching about glargine and regular insulin has been successful?

• A. The patient administers the glargine 30 minutes before each meal
• B. The patient’s family prefills the syringes with the mix of insulins weekly.
• C. The patient draws up the regular insulin and then the glargine in the same syringe.
• D. The patient disposes of the open vials of glargine and regular insulin after 4 weeks

Correct answer: D

Rationale:

5. A client discharges AMA (against medical advice). This is an example of the _________ type of risk category?

• A. nurse-focused
• B. physician-focused
• C. medical-legal incident
• D. Patient-focused

Correct answer: C

Rationale: When a client discharges AMA, it falls under the medical-legal incident risk category. This choice focuses on the legal aspect of the situation, as it involves the patient's right to make decisions about their care, informed consent, and the associated legal implications. Choices A and B are incorrect as they unnecessarily specify individual healthcare roles and do not encompass the broader legal implications of discharging against medical advice. Choice D, patient-focused, is also incorrect as it doesn't capture the legal and risk-related aspects of the scenario.

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