Nursing Elites

1. When a nurse observes a fellow nurse preparing an incorrect dose of medication, what is the best action to take?

• A. Ignore the error
• B. Administer the medication anyway
• C. Correct the error without informing the nurse
• D. Report the error to the supervisor immediately

Correct answer: D

Rationale: The best action to take when a nurse observes a fellow nurse preparing an incorrect dose of medication is to report the error to the supervisor immediately. Reporting the error is crucial to ensure patient safety and prevent any potential harm. Ignoring the error (Choice A) is not appropriate as it puts the patient at risk. Administering the medication anyway (Choice B) could harm the patient. Correcting the error without informing the nurse (Choice C) does not address the root cause of the issue, which should be brought to the attention of the supervisor for proper investigation and resolution.

2. Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)?

• A. The patient’s blood glucose level is 174 mg/dL.
• B. The patient has gained 2 lb (0.9 kg) since yesterday.
• C. The patient is scheduled for a chest x-ray in an hour
• D. The patient’s blood urea nitrogen (BUN) level is 52 mg/dL.

Correct answer: D

Rationale:

3. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

4. During a physical assessment of adult clients, which of the following techniques should the nurse use?

• A. Use the Face, Legs, Activity, Cry, and Consolability (FLACC) pain rating scale for a client experiencing pain.
• B. Palpate the client's abdomen before auscultating bowel sounds.
• C. Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.
• D. Obtain an apical heart rate by auscultating at the third intercostal space to the left of the sternum.

Correct answer: B

Rationale: When performing a physical assessment, it is essential to palpate the client's abdomen before auscultating bowel sounds. This sequence helps prevent altering bowel sound results due to the pressure applied during palpation. Choice A is incorrect because the FLACC pain rating scale is typically used for nonverbal or pediatric clients, not adults. Choice C is incorrect because the bladder of the blood pressure cuff should surround about 80% of the client's arm circumference, not the bladder of the cuff itself. Choice D is incorrect because to obtain an apical heart rate, auscultation should be done at the fifth intercostal space at the midclavicular line, not at the third intercostal space to the left of the sternum.

5. What is the main goal of a nursing quality improvement (QI) program?

• A. To enhance patient safety
• B. To reduce healthcare costs
• C. To ensure regulatory compliance
• D. To maintain high patient satisfaction

Correct answer: A

Rationale: The main goal of a nursing quality improvement (QI) program is to enhance patient safety. While reducing healthcare costs, ensuring regulatory compliance, and maintaining high patient satisfaction are important aspects of healthcare delivery, the primary focus of a QI program in nursing is to improve patient safety through practices such as error reduction, risk management, and enhancing the quality of care provided.

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