Nursing Elites

1. A nurse is teaching a client who has a new prescription for lisinopril. Which of the following statements should the nurse include?

• A. You should expect to develop a dry cough while taking this medication.
• B. This medication can cause a slow heart rate.
• C. You should increase your intake of foods high in potassium.
• D. You should avoid using salt substitutes while taking this medication.

Correct answer: D

Rationale: The correct statement to include when teaching a client prescribed with lisinopril is that they should avoid using salt substitutes while taking this medication. Lisinopril can cause hyperkalemia, which is an elevated level of potassium in the blood. Therefore, using salt substitutes that contain potassium can worsen this condition. Choices A, B, and C are incorrect because lisinopril is not typically associated with causing a dry cough or a slow heart rate, and increasing potassium intake can be harmful in the presence of lisinopril-induced hyperkalemia.

2. A nurse is assessing a client who has a history of urinary incontinence. Which of the following findings should the nurse report to the provider?

• A. Urine output of 50 mL in 2 hours
• B. Presence of an indwelling urinary catheter
• C. Frequent urination at night
• D. Dark-colored urine

Correct answer: D

Rationale: The correct answer is D, dark-colored urine. Dark-colored urine can indicate various issues such as dehydration, liver problems, or blood in the urine, which could be concerning and require further evaluation by the provider. Choices A, B, and C are not necessarily findings that would need immediate reporting to the provider. A urine output of 50 mL in 2 hours might be low but could be influenced by various factors and might not always require immediate action. The presence of an indwelling urinary catheter is a known history and not a new finding. Frequent urination at night could be a symptom related to various conditions but may not be an urgent concern unless accompanied by other significant symptoms.

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 nurse in a pediatric clinic is reviewing laboratory findings for a school-age child. Which of the following findings should the nurse report to the provider?

• A. Hgb 12.5 g/dL
• B. Platelets 250,000/mm3
• C. WBC 14,000/mm3
• D. Hct 40%

Correct answer: D

Rationale: The correct answer is D: 'Hct 40%'. An abnormal hematocrit (Hct) level can indicate various conditions such as dehydration, overhydration, or blood disorders, and requires immediate attention from the healthcare provider. Choices A, B, and C are within normal ranges and do not typically warrant immediate provider notification. Hgb 12.5 g/dL (Choice A) is a normal hemoglobin level, Platelets 250,000/mm3 (Choice B) is a normal platelet count, and WBC 14,000/mm3 (Choice C) is slightly elevated but not significantly high to require urgent reporting.

5. A client has a new ileostomy. Which of the following actions should the nurse take?

• A. Apply a skin barrier around the stoma.
• B. Empty the pouch when it is one-third full.
• C. Change the entire pouching system weekly.
• D. Cleanse the peristomal skin with alcohol.

Correct answer: C

Rationale: Changing the entire pouching system weekly is essential for maintaining skin integrity and preventing infection. Option A is incorrect as applying a skin barrier should be done during the pouch change, not separately. Option B is incorrect as ileostomy pouches should be emptied when they are one-third to one-half full to prevent leakage. Option D is incorrect because cleansing the peristomal skin with alcohol can be too harsh and may cause skin irritation.

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