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. From a unit perspective, disruptive and violent patient behavior may be distracting to patients and staff. As the nurse manager, you are concerned about: (EXCEPT)

• A. Patient and staff safety.
• B. Team tension.
• C. Fear of disappointment.
• D. Stress levels.

Correct answer: C

Rationale: Disruptive and violent patient behavior can indeed pose challenges on a unit. Concerns as a nurse manager would revolve around patient and staff safety (Choice A) due to the risk of harm, team tension (Choice B) arising from managing such situations, and stress levels (Choice D) of both patients and staff. Fear of disappointment (Choice C) is not a typical concern in this scenario and does not directly relate to the immediate impact of disruptive and violent patient behavior.

3. Which of the following is a challenge the profession of nursing faced?

• A. Nursing contributing to the stigma of AIDS in the 1980s out of fear.
• B. Nursing practice flourishing in field hospitals during the Korean War with abundant supplies and equipment.
• C. Many nurses feeling frustrated with the lack of independent functioning after the Vietnam War.
• D. A decline in the number of hospice nurses due to ethical dilemmas.

Correct answer: C

Rationale: The correct answer is C. After the Vietnam War, many nurses felt frustrated with the lack of independent functioning when they returned home. This challenge was faced by the profession of nursing as nurses who functioned independently in mobile hospital units during the war found themselves restricted in their practice upon returning. Choices A, B, and D are incorrect because they do not address the specific challenge of lack of independent functioning faced by nurses after the Vietnam War.

4. What is the primary goal of infection control practices in healthcare settings?

• A. To reduce the length of hospital stays
• B. To ensure patient safety and prevent infections
• C. To control the spread of infections within the healthcare setting
• D. To comply with healthcare regulations

Correct answer: C

Rationale: The correct answer is C: 'To control the spread of infections within the healthcare setting.' The primary goal of infection control practices is to prevent the transmission and spread of infections among patients, healthcare workers, and visitors. Choice A is incorrect because while infection control practices may indirectly contribute to shorter hospital stays by preventing additional complications, reducing the length of hospital stays is not their primary goal. Choice B is incorrect as ensuring patient safety and preventing infections are important outcomes of infection control practices but not the primary goal. Choice D is incorrect because compliance with healthcare regulations is a requirement that supports the implementation of infection control practices but is not the primary goal of these practices.

5. A nurse enters a client's room and finds them on the floor. The client's roommate reports that the client was trying to get out of bed and fell over the side rail onto the floor. Which of the following statements should the nurse document about this incident?

• A. Incident report completed.
• B. Client climbed over the side rails.
• C. Client was trying to get out of bed.
• D. Client found lying on floor.

Correct answer: C

Rationale: The correct answer is C: "Client was trying to get out of bed." This statement accurately reflects the sequence of events leading to the client's fall and provides crucial information for assessing the situation. Choice A is incorrect because documenting the completion of an incident report is not relevant to describing the incident itself. Choice B incorrectly states that the client climbed over the side rails, which is not supported by the information provided. Choice D is too vague and does not provide details about the client's actions prior to falling.

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