Nursing Elites

1. A nurse manager on an acute care unit is preparing a staff presentation about promoting cost-effective care. Which of the following strategies should the nurse plan to include in the presentation?

• A. Change IV solution bags every 36 hr.
• B. Avoid the delegation of hygiene care to assistive personnel (AP)
• C. Wear sterile gloves when removing urinary retention catheters.
• D. Educate staff about the correct use of personal protective equipment (PPE) for isolation precautions

Correct answer: D

Rationale: Teaching staff proper use of PPE helps reduce the spread of infections and promotes cost-effective care.

2. A healthcare professional is reviewing the medical record of a client who received their medications 1 hour ago. The client reports chest pain. This can be an adverse effect of what medication?

• A. Digoxin
• B. Albuterol
• C. Lisinopril
• D. Metoprolol

Correct answer: B

Rationale: The correct answer is B, Albuterol. Albuterol can cause chest pain as a side effect due to its beta-agonist effects, which can lead to chest discomfort. Digoxin (choice A) is not typically associated with causing chest pain. Lisinopril (choice C) and Metoprolol (choice D) are not known to commonly cause chest pain as a side effect.

3. Which finding in a postoperative patient requires immediate intervention by the nurse?

• A. Heart rate of 88 beats per minute.
• B. Blood pressure of 130/80 mmHg.
• C. Crackles heard in the lung bases.
• D. Oxygen saturation of 88% on room air.

Correct answer: D

Rationale: In a postoperative patient, an oxygen saturation level of 88% on room air indicates a significant drop below the normal range, suggesting potential respiratory distress. This finding requires immediate intervention by the nurse to ensure the patient receives adequate oxygenation. A heart rate of 88 beats per minute is within the normal range, making it a less concerning finding. A blood pressure of 130/80 mmHg falls within the normal range for blood pressure and does not require immediate intervention. Crackles heard in the lung bases may indicate fluid accumulation but may not always require immediate intervention unless accompanied by other concerning signs or symptoms.

4. A patient with a urinary catheter reports discomfort. What is the nurse's priority action?

• A. Ensure the catheter tubing is not kinked.
• B. Irrigate the catheter to relieve the discomfort.
• C. Change the catheter to a smaller size.
• D. Remove the catheter and replace it with a new one.

Correct answer: A

Rationale: The correct answer is to ensure the catheter tubing is not kinked. This is the priority action because a kinked tubing can obstruct urine flow, leading to discomfort and potential complications. It is essential to troubleshoot the current catheter first before considering other interventions. Irrigating the catheter (Choice B) may not address the underlying issue of kinking. Changing the catheter to a smaller size (Choice C) or removing and replacing it with a new one (Choice D) should only be considered if ensuring the tubing is unkinked does not resolve the discomfort.

5. What are the key components of a pain assessment in a postoperative patient?

• A. Checking the effectiveness of pain interventions
• B. Observing for nonverbal signs of pain like grimacing
• C. Assessing the location, duration, and quality of the pain
• D. Asking the patient to rate their pain on a scale of 1-10

Correct answer: A

Rationale: The correct answer is A because in a postoperative patient, it is crucial to evaluate the effectiveness of the pain interventions that have been implemented. While choices B, C, and D are important aspects of a pain assessment, they do not specifically address the key component of assessing the effectiveness of the interventions applied postoperatively.

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