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. In the emergency department, a nurse is performing triage for multiple clients following a disaster in the community. To which of the following types of injuries should the nurse assign the highest priority?

• A. Below-the-knee amputation.
• B. 10 cm (4 in) laceration.
• C. Fractured tibia.
• D. 95% full-thickness body burn.

Correct answer: A

Rationale: A below-the-knee amputation requires immediate attention due to the risk of hemorrhage and shock, making it the highest priority. This type of injury can lead to significant blood loss and impaired perfusion, which can be life-threatening if not addressed promptly. While a 10 cm laceration, a fractured tibia, and a 95% full-thickness body burn are serious injuries requiring urgent care, they do not pose the same immediate threat to life as a below-the-knee amputation. The laceration may require suturing to control bleeding and prevent infection, the fractured tibia needs stabilization to prevent further damage and pain, and the burn necessitates immediate management to prevent complications, but they are not as acutely life-threatening as the amputation.

3. When providing discharge teaching to a client with diabetes, what is the most important instruction?

• A. Check blood sugar levels once daily
• B. Administer insulin as prescribed before meals
• C. Take medication only when feeling unwell
• D. Eat carbohydrate-rich meals to stabilize blood sugar

Correct answer: B

Rationale: Administering insulin as prescribed before meals is crucial for managing diabetes. This instruction is vital as it helps the client maintain blood sugar levels within the target range. Checking blood sugar levels once daily is important but not as critical as ensuring the timely administration of insulin. Taking medication only when feeling unwell is dangerous as it may lead to uncontrolled blood sugar levels. Eating carbohydrate-rich meals may actually destabilize blood sugar levels rather than stabilizing them, making it an incorrect choice.

4. How can a healthcare professional reduce the risk of falls in elderly patients?

• A. Encourage the use of assistive devices.
• B. Clear walkways.
• C. Ensure proper lighting.
• D. All of the above.

Correct answer: D

Rationale: All of these interventions are crucial in reducing the risk of falls in elderly patients. Encouraging the use of assistive devices helps provide support and stability, clearing walkways minimizes tripping hazards, and ensuring proper lighting enhances visibility and reduces the chances of falls. Therefore, choosing 'All of the above' is the most appropriate answer as each intervention plays a significant role in fall prevention.

5. When a client with dementia frequently becomes agitated, what should the nurse prioritize investigating?

• A. Fluid and electrolyte imbalances
• B. Medication history
• C. Environmental factors
• D. Cognitive functioning

Correct answer: B

Rationale: The correct answer is to prioritize investigating the client's medication history. This is important because certain medications can contribute to agitation in clients with dementia. Understanding the medication history can help identify potential causes of agitation and guide appropriate interventions. Checking for fluid and electrolyte imbalances is important in healthcare but may not directly relate to the client's agitation. While environmental factors can influence behavior, investigating the medication history is more pertinent in this case. Cognitive functioning assessment is crucial in dementia care but may not be the priority when addressing acute agitation.

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