Nursing Elites

1. A healthcare professional is preparing to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the healthcare professional delegate?

• A. Confirming that a client's pain has decreased after receiving an analgesic
• B. Ambulating a client who is postoperative
• C. Inserting an indwelling urinary catheter for a client
• D. Demonstrating the use of an incentive spirometer to a client

Correct answer: A

Rationale: The correct answer is option A: 'Confirming that a client's pain has decreased after receiving an analgesic.' This task involves assessing the effectiveness of the medication, which can be delegated to the assistive personnel. Options B, C, and D involve skills that should be performed by licensed healthcare professionals due to their complexity and potential risks if not done correctly. Ambulating a postoperative client requires monitoring for signs of distress or complications, inserting a urinary catheter involves an invasive procedure with infection risks, and demonstrating the use of medical devices like an incentive spirometer requires specialized knowledge to ensure correct usage.

2. A healthcare professional is admitting a client who has rubella. Which of the following types of transmission-based precautions should the nurse initiate?

• A. Airborne
• B. Protective environment
• C. Contact
• D. Droplet

Correct answer: B

Rationale: The correct answer is 'B: Protective environment.' Rubella requires placing the client in a protective environment due to its airborne precautions. Airborne precautions are typically used for diseases that are spread through tiny droplets that remain in the air for an extended period, like tuberculosis. Contact precautions are used for diseases that are spread by direct or indirect contact, such as MRSA. Droplet precautions are implemented for diseases transmitted through respiratory droplets, like influenza. Therefore, in the case of rubella, airborne precautions in a protective environment are necessary.

3. There are several pitfalls that should be avoided when using social media of any type. For example, a nurse or student could be found guilty of libel in which of the following scenarios?

• A. Snapping a selfie with a patient
• B. Posting a positive review of the hospital where the student completed clinicals
• C. Creating a closed online forum where students can discuss clinical experiences without providing client information
• D. Complaining about her nurse preceptor on social media, discussing the preceptor�s unprofessional characteristics.

Correct answer: D

Rationale: Statements about individuals encountered in one�s professional or educational life that could damage that person�s reputation may be slander or libel and can be prosecuted as quasi-intentional torts.

4. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?

• A. Document the surgeon's instructions in the client's medical record.
• B. Complete an incident report.
• C. Consult the charge nurse.
• D. Notify the nursing manager.

Correct answer: D

Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.

5. When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the healthcare provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may

• A. require administration of insulin while taking prednisone
• B. develop acute hypoglycemia while taking prednisone
• C. require administration of insulin while taking prednisone
• D. have rashes caused by metformin-prednisone interactions

Correct answer: C

Rationale: When a patient taking metformin develops an allergic rash from an unknown cause and is prescribed prednisone, the nurse should anticipate that the patient may require administration of insulin while taking prednisone. Prednisone can increase blood glucose levels by antagonizing the effects of insulin, leading to hyperglycemia. Therefore, the patient may need additional insulin to manage blood sugar levels effectively. The other options are incorrect as prednisone would not directly cause a need for a higher-calorie diet, acute hypoglycemia, or rashes caused by a metformin-prednisone interaction.

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