Nursing Elites

1. A nurse is completing an incident report after a client fall. Which of the following competencies of Quality and Safety Education for Nurses is the nurse demonstrating?

• A. Quality improvement
• B. Patient safety
• C. Evidence-based practice
• D. Informatics

Correct answer: A

Rationale: The correct answer is A: Quality improvement. Completing an incident report after a client fall aligns with the quality improvement competency of QSEN, as it involves identifying a system issue (fall incident) that needs to be addressed to enhance the quality of care. Choice B, patient safety, focuses more on preventing harm to patients rather than the systematic improvement process. Choice C, evidence-based practice, pertains to integrating research evidence with clinical expertise and patient values in decision-making, which is not directly related to incident reporting. Choice D, informatics, involves using technology and data to support decision-making and improve patient care, which is not the primary focus when completing an incident report.

2. A nurse is providing education to a client who is at 28 weeks gestation and has gestational diabetes mellitus. Which of the following statements should the nurse make?

• A. You will need to increase your protein intake during pregnancy.
• B. It is important to monitor your blood glucose levels closely.
• C. Gestational diabetes can increase the risk of developing type 2 diabetes later in life.
• D. You will need to avoid exercise while managing your blood sugar.

Correct answer: C

Rationale: The correct statement the nurse should make is that gestational diabetes can increase the risk of developing type 2 diabetes later in life. This information is crucial for the client's understanding of the potential long-term implications of gestational diabetes. Monitoring blood glucose levels closely (Choice B) is also important but does not address the long-term risk of developing type 2 diabetes. Choices A and D are incorrect as increasing protein intake during pregnancy and avoiding exercise are not recommended strategies for managing gestational diabetes.

3. A client is receiving discharge teaching regarding a new prescription for amoxicillin. Which of the following client statements indicates an understanding of the teaching?

• A. I will take this medication until my symptoms are gone.
• B. I will take this medication until it is finished.
• C. I will take this medication on an empty stomach.
• D. I will take this medication with milk.

Correct answer: B

Rationale: The correct answer is B. It is crucial for clients to complete the entire course of antibiotics as prescribed, even if symptoms improve. This helps to ensure that the infection is fully treated and reduces the risk of developing antibiotic resistance. Choice A is incorrect because stopping the medication when symptoms disappear can lead to incomplete treatment. Choice C is incorrect as amoxicillin can be taken with or without food. Choice D is incorrect because taking amoxicillin with milk can decrease its absorption.

4. While reviewing the monitor tracing of a client in labor, a nurse notes late decelerations. Which of the following interventions should the nurse perform?

• A. Administer oxygen via nasal cannula
• B. Reposition the client onto her left side
• C. Administer an amnioinfusion
• D. Provide reassurance to the client

Correct answer: B

Rationale: Repositioning the client onto her left side is the appropriate intervention when late decelerations are noted on the monitor tracing. This action helps increase uteroplacental blood flow by relieving pressure on the vena cava and aorta, improving fetal oxygenation. Administering oxygen via nasal cannula may be indicated for variable decelerations, not late decelerations. Administering an amnioinfusion is not the primary intervention for late decelerations. Providing reassurance to the client is important but addressing the underlying cause of late decelerations takes precedence.

5. A nurse is caring for a client who is receiving chemotherapy. Which of the following findings should the nurse report to the provider?

• A. Alopecia
• B. Weight gain of 1 kg (2.2 lb) in 24 hours
• C. White blood cell count of 6,000/mm³
• D. Temperature of 37.2°C (99°F)

Correct answer: B

Rationale: The correct answer is B. A weight gain of 1 kg (2.2 lb) in 24 hours is concerning as it indicates fluid retention, which can be a sign of complications in clients receiving chemotherapy. Rapid weight gain can be associated with conditions like fluid overload or electrolyte imbalances, which need prompt medical attention. Choices A, C, and D are not typically immediate concerns related to chemotherapy. Alopecia (choice A) is a common side effect of chemotherapy, a white blood cell count of 6,000/mm³ (choice C) falls within the normal range, and a temperature of 37.2°C (99°F) (choice D) is slightly elevated but not a critical finding in this context.

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