Nursing Elites

1. During an initial assessment of a client, a nurse notices a discrepancy between the client's current IV infusion and the information received during the shift report. Which of the following actions should the nurse take?

• A. Complete an incident report and place it in the client's medical record.
• B. Compare the current infusion with the prescription in the client's medication record.
• C. Contact the charge nurse to see if the prescription was changed.
• D. Submit a written warning for the nurse involved in the incident.

Correct answer: B

Rationale: The correct action for the nurse to take when noticing a discrepancy between the client's current IV infusion and the information received during the shift report is to compare the current infusion with the prescription in the client's medication record. This step is crucial to ensure the accuracy of the prescribed treatment and to prevent any potential harm to the client. Option A is incorrect because completing an incident report should only be done after verifying the discrepancy. Option C is incorrect as contacting the charge nurse should come after confirming the details. Option D is incorrect as submitting a written warning is not appropriate without verifying the information first.

2. A nurse is preparing to administer a medication to a client. The client states, 'I'm sick of all these medications, and I'm not taking any more today!' Which of the following actions should the nurse take?

• A. Ask the client to discuss their feelings
• B. Explain the importance of the medications
• C. Document the refusal and withhold the medication
• D. Inform the client of the possible consequences of refusal

Correct answer: D

Rationale: When a client refuses medication, the nurse should inform the client of the possible consequences of refusal. This action helps the client understand the risks associated with not taking the medication. Asking the client to discuss their feelings (choice A) is important but should follow after informing them of the consequences. Explaining the importance of the medications (choice B) might not address the immediate concern of the client. Documenting the refusal and withholding the medication (choice C) should be done after informing the client of the consequences and attempting to address their concerns.

3. A client who is postpartum is being taught about breast care by a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will wear tight-fitting bras to reduce discomfort
• B. I will nurse my baby frequently to prevent engorgement
• C. I will pump my breasts every 4 hours
• D. I will avoid nursing for at least 48 hours

Correct answer: B

Rationale: The correct answer is B. Nursing the baby frequently helps prevent engorgement and discomfort in breastfeeding mothers. Choice A is incorrect because tight-fitting bras can lead to clogged milk ducts and worsen discomfort. Choice C may lead to oversupply issues and is not necessary unless there is a specific indication. Choice D is incorrect as avoiding nursing for extended periods can lead to engorgement and decreased milk supply.

4. What are the key considerations for managing a patient with chronic obstructive pulmonary disease (COPD)?

• A. Airway Management
• B. Oxygen Therapy
• C. Smoking Cessation
• D. Pulmonary Rehabilitation

Correct answer: A

Rationale: The key considerations for managing a patient with COPD include airway management, ensuring adequate oxygenation, promoting smoking cessation, and incorporating pulmonary rehabilitation. While airway management is crucial for maintaining patency and preventing exacerbations, oxygen therapy helps improve oxygen levels in the blood. Smoking cessation is essential to slow down disease progression and reduce exacerbation risk. Pulmonary rehabilitation plays a vital role in enhancing exercise tolerance and overall quality of life for COPD patients. Therefore, while all options are important in managing COPD, airway management is the most critical aspect.

5. A nurse is providing discharge instructions for a client using home oxygen. What is the most important safety measure?

• A. Store oxygen tanks in a closet when not in use
• B. Ensure that oxygen tanks are kept upright and away from heat sources
• C. Allow family members to smoke in designated areas
• D. Restrict fluid intake while using oxygen

Correct answer: B

Rationale: The correct answer is B: Ensure that oxygen tanks are kept upright and away from heat sources. This is the most important safety measure to prevent accidents related to home oxygen use. Storing oxygen tanks in a closet when not in use (choice A) is not recommended as they should be stored in a well-ventilated area. Allowing family members to smoke in designated areas (choice C) poses a significant fire hazard. Restricting fluid intake while using oxygen (choice D) is not a safety measure related to oxygen use.

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