Nursing Elites

1. A nurse is caring for a client who requires total parenteral nutrition (TPN). Which of the following actions should the nurse take when finding that the TPN solution is infusing too rapidly?

• A. Sit the client upright
• B. Stop the TPN infusion
• C. Turn the client on their left side
• D. Prepare to add insulin to the TPN infusion

Correct answer: B

Rationale: The correct action for the nurse to take when finding that the TPN solution is infusing too rapidly is to stop the TPN infusion. This is crucial to prevent fluid overload and ensure the client's safety. Sitting the client upright (Choice A) or turning the client on their left side (Choice C) are not appropriate responses to a rapidly infusing TPN solution and do not address the immediate issue of preventing complications from the rapid infusion. Adding insulin to the TPN infusion (Choice D) is not indicated unless specifically prescribed by the healthcare provider for the client's condition. Therefore, the priority action is to stop the TPN infusion to prevent potential harm.

2. A nurse manager is teaching a group of employees about standards for Quality and Safety Education for Nurses (QSEN). Which of the following statements by an employee should the nurse manager identify as an example of the QSEN concept of quality improvement?

• A. We should start tracking how soon clients are discharged after laparoscopic versus open surgery.
• B. We should involve our clients' partners in care planning as much as possible.
• C. We should be sure to log out of the computers immediately following documentation.
• D. We should provide change-of-shift report as a team, including the assistive personnel who assisted with care.

Correct answer: B

Rationale: Involving partners in care planning is a quality improvement strategy that aligns with QSEN principles. This choice reflects patient-centered care and collaboration, which are essential elements of quality improvement. Choices A, C, and D do not directly relate to quality improvement concepts. Tracking discharge times, logging out of computers, and providing change-of-shift reports are important practices but not specifically focused on quality improvement.

3. A healthcare professional is teaching a patient how to prevent falls at home. Which instruction is most appropriate?

• A. Keep your living space well-lit.
• B. Remove loose rugs and install grab bars in the bathroom.
• C. Use furniture to provide support when walking.
• D. Wear socks without shoes to prevent slipping.

Correct answer: B

Rationale: The most appropriate instruction to prevent falls at home is to remove loose rugs and install grab bars in high-risk areas like the bathroom. This helps eliminate tripping hazards and provides stability for the patient. Keeping the living space well-lit (Choice A) is important but may not directly address fall prevention. Using furniture for support (Choice C) can lead to accidents if the furniture is not stable. Wearing socks without shoes (Choice D) increases the risk of slipping rather than preventing falls.

4. A healthcare provider is providing dietary teaching for a client who has a burn injury and adheres to a vegan diet. The healthcare provider should recommend which of the following foods as the best source of protein to promote wound healing?

• A. One cup of brown rice
• B. One cup of pureed avocado
• C. One cup of lentils
• D. One cup of orange juice

Correct answer: C

Rationale: Lentils are an excellent source of protein, suitable for a vegan diet, and promote wound healing. Brown rice (Choice A) is a carbohydrate-rich food and lacks sufficient protein for wound healing. Pureed avocado (Choice B) is a healthy fat source but low in protein. Orange juice (Choice D) is a source of vitamin C but lacks protein needed for wound healing.

5. A healthcare provider writes a prescription for a medication dose three times the normal range. What should the nurse do?

• A. Administer the medication as prescribed
• B. Question the prescription with the provider
• C. Consult with the pharmacist about the dosage
• D. Delay the medication until verification can be made

Correct answer: B

Rationale: The correct action for the nurse in this situation is to question the prescription with the provider. Administering a medication dose three times the normal range without clarification could pose serious risks to the client. Consulting with the pharmacist about the dosage or delaying the medication until verification can be made are not the initial steps to take; the nurse should first clarify the prescription with the healthcare provider to ensure patient safety.

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