Nursing Elites

1. A client with osteoporosis is being taught by a nurse how to prevent further bone loss. Which of the following instructions should the nurse include?

• A. Take a calcium supplement daily.
• B. Perform weight-bearing exercises.
• C. Avoid weight-bearing exercises.
• D. Limit intake of high-phosphorus foods.

Correct answer: B

Rationale: The correct answer is B: Perform weight-bearing exercises. Weight-bearing exercises are essential for preventing further bone loss and improving bone density in clients with osteoporosis. Calcium supplements alone may not be sufficient to prevent bone loss without adequate physical activity. Option C, 'Avoid weight-bearing exercises,' is incorrect as these exercises are beneficial for bone health. Option D, 'Limit intake of high-phosphorus foods,' is not directly related to preventing further bone loss in osteoporosis.

2. How should a healthcare provider care for a patient who is refusing medication?

• A. Assess the reasons for refusal
• B. Explore alternative treatment options
• C. Document the refusal
• D. Discontinue the medication

Correct answer: A

Rationale: When a patient refuses medication, it is essential for the healthcare provider to assess the reasons for refusal. This allows the provider to understand the patient's concerns, provide education or clarification if needed, and work collaboratively with the patient to find a solution. Exploring alternative treatment options may be necessary after understanding the reasons behind the refusal. Documenting the refusal is important for legal and continuity of care purposes, but it is not the initial action to take. Discontinuing the medication without understanding the patient's reasons for refusal can lead to potential harm and is not a recommended approach.

3. 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.

4. A client with bipolar disorder and experiencing mania is under the care of a nurse. Which intervention should the nurse include in the plan?

• A. Encourage the client to spend time in the day room.
• B. Withdraw the client's TV privileges if they do not attend group therapy.
• C. Encourage the client to take frequent rest periods.
• D. Place the client in seclusion when they exhibit signs of anxiety.

Correct answer: C

Rationale: Encouraging the client to take frequent rest periods is an appropriate intervention for managing mania in a client with bipolar disorder. During a manic episode, individuals often have increased energy levels, decreased need for sleep, and may engage in high-risk behaviors. Encouraging regular rest periods can help reduce stimulation and promote relaxation, which may assist in stabilizing mood. Choices A and B are not as effective in managing manic symptoms, as they do not directly address the client's need for rest and relaxation. Choice D is inappropriate because placing the client in seclusion can increase feelings of anxiety and agitation, worsening the manic episode.

5. A nurse is preparing a sterile field for a client with a surgical wound. Which of the following actions should the nurse take to maintain the sterile field?

• A. Open sterile packages using the flap closest to your body first.
• B. Don sterile gloves before opening the sterile package.
• C. Avoid reaching over the sterile field.
• D. Place sterile items at least 2.5 cm (1 in) from the edge of the sterile field.

Correct answer: C

Rationale: The correct action to maintain a sterile field is to avoid reaching over it. This prevents contamination of the sterile environment by reducing the risk of unintentionally dropping microorganisms from non-sterile areas onto the sterile field. Opening sterile packages using the flap closest to your body first (choice A) is a good practice but not directly related to maintaining the sterile field. Donning sterile gloves before opening the sterile package (choice B) is crucial for maintaining sterility but not specific to maintaining the sterile field. Placing sterile items at least 2.5 cm (1 in) from the edge of the sterile field (choice D) is important to prevent accidental contamination, but it is not the primary action to maintain the sterile field.

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