Nursing Elites

1. A nurse manager of a med surge unit is assigning care responsibilities for the oncoming shift. A client is waiting transfer back to the unit from the PACU following thoracic surgery. To which staff member should the nurse assign the client?

• A. Charge nurse
• B. RN
• C. LVN
• D. AP

Correct answer: B

Rationale: The correct answer is B: RN. An RN is required for managing post-surgical care in the immediate postoperative period, especially for a client following thoracic surgery. The RN is equipped with the necessary knowledge and skills to assess the client's condition, provide complex care, and recognize and respond to any complications that may arise. Assigning the client to the Charge nurse (A) may not be appropriate as the Charge nurse focuses more on administrative and managerial tasks rather than direct patient care. LVNs (C) and APs (D) may have limitations in their scope of practice when it comes to managing post-surgical care following thoracic surgery, which requires a higher level of assessment and intervention that an RN can provide.

2. A nurse is collecting data from a client who has Tourette syndrome. The client reports taking haloperidol 0.5 mL orally three times a day at home. Which of the following components of the prescription should the nurse question?

• A. Frequency
• B. Dosage
• C. Timing of doses
• D. Route

Correct answer: B

Rationale: The nurse should question the dosage of haloperidol as it is typically administered in milligrams (mg) and not milliliters (mL). The dosage should be expressed in a standardized unit for accuracy and to prevent medication errors. Frequency, timing of doses, and route are also important components of a prescription, but in this case, the nurse should focus on the unusual dosage form.

3. A nurse is planning care for a preschool-age child who is in the acute phase of Kawasaki disease. Which of the following interventions should the nurse include in the plan of care?

• A. Administer scheduled doses of acetaminophen every 6 hr.
• B. Monitor the child's cardiac status.
• C. Administer antibiotics via intermittent IV bolus for 24 hr.
• D. Provide stimulation with children of the same age in the playroom.

Correct answer: B

Rationale: Monitoring cardiac status is crucial during the acute phase of Kawasaki disease because of the potential for coronary artery complications. Acetaminophen may be used for fever management but is not the priority intervention. Antibiotics are not indicated as Kawasaki disease is not caused by a bacterial infection. Providing stimulation in the playroom is important for the child's emotional well-being but does not address the immediate physiological concern of cardiac monitoring.

4. What should be included in dietary teaching for a client with chronic kidney disease?

• A. Increase potassium-rich foods in the diet
• B. Limit potassium and phosphorus intake
• C. Increase intake of protein-rich foods
• D. Increase fluid intake to prevent dehydration

Correct answer: B

Rationale: The correct answer is to limit potassium and phosphorus intake for a client with chronic kidney disease. Excessive potassium and phosphorus can be harmful to individuals with compromised kidney function. Option A is incorrect because increasing potassium-rich foods can exacerbate hyperkalemia in individuals with kidney disease. Option C may not be ideal as excessive protein intake can put extra strain on the kidneys. Option D is not the priority; while adequate fluid intake is important, it is not the primary focus when teaching dietary considerations for chronic kidney disease.

5. How should a healthcare professional respond to a patient with diabetic ketoacidosis (DKA)?

• A. Administer insulin
• B. Administer IV fluids
• C. Monitor blood glucose
• D. All of the above

Correct answer: D

Rationale: When managing a patient with diabetic ketoacidosis (DKA), it is crucial to administer insulin to lower blood sugar levels, administer IV fluids to correct dehydration and electrolyte imbalances, and monitor blood glucose levels regularly to ensure they are within the target range. Therefore, all of the above options are essential components of the comprehensive treatment plan for DKA. Administering insulin alone may lower blood sugar levels but will not address the fluid and electrolyte imbalances seen in DKA. Similarly, administering IV fluids alone may help with dehydration but will not address the high blood sugar levels or the need for insulin. Monitoring blood glucose alone is not sufficient to treat DKA; it must be accompanied by appropriate interventions to address the underlying causes and complications of the condition.

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