Nursing Elites

1. A healthcare professional is preparing information for a change-of-shift report. Which of the following information should the healthcare professional include in the report?

• A. Input and output measurements for the shift
• B. Blood pressure readings from the previous day
• C. Bone scan scheduled for today
• D. Medication regimen from the medication administration record

Correct answer: D

Rationale: During a change-of-shift report, healthcare professionals should include the medication regimen from the medication administration record. This information ensures continuity of care and helps incoming staff understand the patient's medication needs and schedule. While input and output measurements, blood pressure readings, and scheduled procedures like a bone scan are important aspects of patient care, they may not be immediately relevant for the incoming shift. Focusing on medication details helps prevent errors and ensures the patient receives the correct medications at the right times.

2. A nurse is receiving the prescription for a client who is experiencing dysphagia following a stroke. Which of the following prescriptions should the nurse clarify?

• A. Dietitian consult
• B. Speech therapy referral
• C. Oral suction at the bedside
• D. Clear liquids

Correct answer: D

Rationale: The correct answer is D: 'Clear liquids.' Clients with dysphagia following a stroke are at risk of aspiration, and clear liquids have a higher risk of aspiration compared to thickened liquids or pureed foods. Therefore, the nurse should clarify the prescription for clear liquids to prevent potential harm to the client. Choices A, B, and C are appropriate interventions for a client with dysphagia following a stroke. A dietitian consult can help modify the client's diet for safe swallowing, speech therapy can assist in improving swallowing function, and oral suction at the bedside helps maintain airway patency and prevents aspiration.

3. A nurse is caring for a client who reports a pain level of 5 on a scale from 0-10. The client informs the nurse that pain medication is not an option for managing pain. Which of the following is an appropriate response by the nurse?

• A. I'm sure it will work if you just give it a chance.
• B. You may take any herbal remedies you bring from home.
• C. Why do you think pain medication is not going to help you?
• D. Would you like me to give you a back massage?

Correct answer: D

Rationale: In this scenario, the client has expressed that pain medication is not an option for managing pain. Offering alternative pain relief options like a back massage is appropriate because it respects the client's preferences and provides a non-pharmacological intervention to help alleviate pain. Choices A, B, and C are not as suitable: A may come across as dismissive of the client's decision, B may not be safe as herbal remedies can interact with medical treatments, and C focuses more on questioning the client's decision rather than providing immediate comfort.

4. A nurse on a medical-surgical unit is caring for a client. Which of the following actions should the nurse take first when using the nursing process?

• A. Obtain client information
• B. Develop a plan of care
• C. Implement nursing interventions
• D. Evaluate the client's response to treatment

Correct answer: A

Rationale: The correct answer is A: Obtain client information. The first step in the nursing process is assessment, which involves gathering data about the client's condition, needs, and preferences. This information forms the foundation for developing a comprehensive plan of care. Developing a plan of care (Choice B) comes after assessment to address the identified needs. Implementing nursing interventions (Choice C) follows the development of the plan of care. Evaluating the client's response to treatment (Choice D) occurs after implementing the interventions to determine the effectiveness of the care provided. Therefore, the initial and priority step is to obtain client information through assessment.

5. A client with chronic kidney disease is receiving epoetin alfa (Epogen). Which laboratory value should the nurse monitor to determine the effectiveness of this medication?

• A. Serum creatinine
• B. Hemoglobin
• C. Blood urea nitrogen (BUN)
• D. Platelet count

Correct answer: B

Rationale: The correct answer is B: Hemoglobin. Epoetin alfa (Epogen) is a medication commonly used in clients with chronic kidney disease to stimulate red blood cell production. Monitoring hemoglobin levels is crucial to assess the effectiveness of epoetin alfa therapy. Hemoglobin levels reflect the oxygen-carrying capacity of the blood and indicate if the medication is successfully treating anemia associated with chronic kidney disease. Option A, serum creatinine, is a marker of kidney function, not the primary indicator of epoetin alfa effectiveness. Option C, blood urea nitrogen (BUN), is a measure of kidney function and hydration status. Option D, platelet count, assesses clotting ability and is unrelated to monitoring the effectiveness of epoetin alfa in treating anemia in chronic kidney disease.

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