Nursing Elites

1. A healthcare provider is caring for four clients. Which of the following tasks can the healthcare provider delegate to an assistive personnel?

• A. Perform chest compressions during cardiac resuscitation
• B. Perform a dressing change for a new amputee
• C. Assess the effectiveness of antiemetic medication
• D. Provide discharge instructions

Correct answer: A

Rationale: Performing chest compressions during cardiac resuscitation is a critical life-saving intervention that can be delegated to an assistive personnel during an emergency. This task requires immediate action and basic training, making it appropriate for delegation. Performing a dressing change for a new amputee involves specialized knowledge and skills, typically performed by licensed healthcare providers. Assessing the effectiveness of medication requires critical thinking and decision-making skills that are within the scope of a licensed healthcare provider. Providing discharge instructions involves educating the patient on post-discharge care and follow-up, which is typically done by a healthcare provider to ensure clear communication and understanding.

2. A client is prescribed digoxin for heart failure. Which of the following should the nurse monitor to evaluate the effectiveness of the medication?

• A. Respiratory rate
• B. Blood pressure
• C. Apical pulse
• D. Urine output

Correct answer: C

Rationale: The correct answer is C: Apical pulse. Digoxin's primary effect is to strengthen the force of the heart's contractions and slow the heart rate. Monitoring the apical pulse is crucial in evaluating the effectiveness of digoxin as it helps assess the medication's impact on the heart's function. Option A, respiratory rate, is not directly related to digoxin's mechanism of action and is not the most appropriate parameter to monitor for this medication. Option B, blood pressure, while important, may not be as sensitive as the apical pulse in assessing the effectiveness of digoxin. Option D, urine output, is more indicative of kidney function and fluid balance, rather than the direct effectiveness of digoxin in heart failure.

3. A healthcare provider is reviewing a client’s care plan. Which of the following goals is most appropriate?

• A. Client will inject insulin twice daily
• B. Client will keep appointments with the healthcare provider for 6 months
• C. Client's A1c will be 5% within one year
• D. Client's blood glucose will stay between 60-120 mg/dL

Correct answer: C

Rationale: The correct answer is C. A1c is a key indicator of long-term diabetes management, reflecting average blood sugar levels over the past 2-3 months. Achieving a target A1c of 5% indicates good control of blood sugar levels and reduces the risk of diabetes-related complications. Choices A, B, and D are not as appropriate as they focus on short-term tasks or individual blood glucose readings, rather than long-term management and outcomes.

4. A client with heart failure is receiving discharge teaching. Which statement by the client indicates an understanding of the teaching?

• A. I will weigh myself once a week.
• B. I will take my diuretic medication in the evening.
• C. I will limit my fluid intake to 3 liters per day.
• D. I will call my doctor if I notice swelling in my feet.

Correct answer: D

Rationale: The correct answer is D. Swelling in the feet can indicate worsening heart failure due to fluid retention, and clients should report this to their healthcare provider immediately. Choices A, B, and C are incorrect because weighing once a week may not provide timely information on fluid retention, timing of diuretic medication is usually advised in the morning to prevent nocturia, and limiting fluid intake to 3 liters per day may not be appropriate for all clients with heart failure.

5. A client is to undergo a liver biopsy. Which of the following instructions should the nurse provide to the client following the procedure?

• A. “Lie on your left side.”
• B. “Lie on your right side.”
• C. “Increase your fluid intake.”
• D. “Decrease your fluid intake.”

Correct answer: B

Rationale: Following a liver biopsy, the nurse should instruct the client to lie on the right side to promote hemostasis. This position helps apply pressure to the biopsy site, reducing the risk of bleeding. Instructing the client to lie on the left side (Choice A) would not provide the same benefit. Increasing fluid intake (Choice C) is generally beneficial post-procedure to prevent dehydration and promote healing. Decreasing fluid intake (Choice D) is not advisable as it can lead to dehydration and potential complications.

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