Nursing Elites

1. A nurse is preparing to administer an IV bolus of 0.9% sodium chloride to a client who is dehydrated. Which of the following actions should the nurse take?

• A. Administer the solution slowly over 24 hours
• B. Assess the client's lung sounds before administration
• C. Change the IV tubing every 12 hours
• D. Flush the IV line with 2 mL of heparin every 4 hours

Correct answer: B

Rationale: The correct action for the nurse to take is to assess the client's lung sounds before administering IV fluids. This is crucial to identify any signs of fluid overload, such as crackles or wheezes. Administering the solution slowly over 24 hours (choice A) is not appropriate for an IV bolus, which is a rapid infusion. Changing the IV tubing every 12 hours (choice C) is a standard practice for preventing infection but is not directly related to administering an IV bolus. Flushing the IV line with heparin every 4 hours (choice D) is a maintenance practice to prevent clot formation in the line, not specifically related to administering an IV bolus.

2. A charge nurse is preparing to lead negotiations among nursing staff due to conflict about overtime requirements. Which of the following strategies should the nurse use to promote effective negotiation?

• A. Identify solutions prior to the negotiation.
• B. Focus on how to resolve the conflict.
• C. Attempt to understand both sides of the issue.
• D. Avoid personalizing the conflict.

Correct answer: C

Rationale: In negotiating conflicts, it is crucial to attempt to understand both sides of the issue. This strategy helps the charge nurse gain insights into the perspectives and concerns of all parties involved, facilitating a more effective negotiation process. Choice A is not ideal as identifying solutions prior to negotiation may overlook important viewpoints or needs. Choice B is vague and does not provide a specific action plan for resolving the conflict. Choice D is incorrect as personalizing the conflict can lead to biased decision-making and hinder the negotiation process.

3. A nurse is caring for a client who has osteoarthritis. Which of the following actions should the nurse take?

• A. Apply heat to inflamed joints
• B. Provide passive range-of-motion exercises
• C. Encourage prolonged use of NSAIDs
• D. Apply cold packs to the joints

Correct answer: A

Rationale: Corrected Rationale: Applying heat to inflamed joints can help relieve pain in clients with osteoarthritis. Heat therapy can help improve blood circulation, relax muscles, and reduce stiffness. Choice B, providing passive range-of-motion exercises, may be beneficial for joint mobility but is not the first-line intervention for pain relief in osteoarthritis. Choice C, encouraging prolonged use of NSAIDs, should be done cautiously due to potential side effects and should be guided by a healthcare provider. Choice D, applying cold packs to the joints, is not recommended for osteoarthritis as cold therapy can worsen stiffness and discomfort in this condition.

4. A nurse is caring for a client who is receiving enteral feedings through an NG tube. Which of the following actions should the nurse take to prevent aspiration?

• A. Flush the NG tube with 0.9% sodium chloride before feedings.
• B. Place the client in a high Fowler's position during feedings.
• C. Administer the feedings over 30 minutes.
• D. Warm the formula before administering it.

Correct answer: B

Rationale: The correct answer is to place the client in a high Fowler's position during enteral feedings. This position helps prevent aspiration by promoting the downward flow of the feeding and reducing the risk of regurgitation into the lungs. Choice A is incorrect because flushing the NG tube with 0.9% sodium chloride before feedings is not directly related to preventing aspiration. Choice C is incorrect because the rate of administration does not directly impact the risk of aspiration. Choice D is incorrect because warming the formula does not specifically address the prevention of aspiration during enteral feedings.

5. A client who is postoperative following a total hip arthroplasty is at risk for hip dislocation. Which of the following actions should the nurse take to prevent this complication?

• A. Position the client supine with a pillow between the legs
• B. Place a pillow under the client's knees
• C. Place an abduction pillow between the client's legs
• D. Place a trochanter roll under the client's legs

Correct answer: C

Rationale: After a total hip arthroplasty, it is crucial to prevent hip dislocation. Placing an abduction pillow between the client's legs helps maintain proper alignment and prevents the hip from dislocating. This position aids in keeping the hip in a neutral or slightly outwardly rotated position, reducing the risk of dislocation. Placing the client supine with a pillow between the legs (Choice A) or using a trochanter roll (Choice D) may not provide the same level of abduction and support needed to prevent hip dislocation. Placing a pillow under the client's knees (Choice B) does not provide the necessary support to maintain proper hip alignment in this situation.

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