Nursing Elites

1. A nurse on a pediatric care unit is delegating client care. Which of the following tasks should the nurse delegate to an assistive personnel?

• A. Initiate a dietary consult for a toddler
• B. Administer a glycerin suppository to a preschool-age child
• C. Evaluate gastric residual following intermittent feeding of an adolescent
• D. Transport a school-age child to x-ray

Correct answer: D

Rationale: The correct answer is D because transporting a stable child to x-ray is a task that can be safely delegated to an assistive personnel. This task does not require clinical judgment or specialized skills. Choices A, B, and C involve assessments and interventions that require nursing judgment and should be performed by a qualified nurse. Initiating a dietary consult for a toddler involves assessing the child's nutritional needs and must be done by a nurse. Administering a glycerin suppository to a preschool-age child requires medication administration skills and knowledge of appropriate dosages, which are within the nurse's scope of practice. Evaluating gastric residual following intermittent feeding of an adolescent is a clinical assessment that requires interpretation and decision-making based on the findings, making it a nursing responsibility.

2. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory findings should the nurse expect?

• A. Decreased serum amylase
• B. Decreased serum lipase
• C. Elevated blood glucose
• D. Elevated calcium levels

Correct answer: C

Rationale: In acute pancreatitis, the nurse should expect elevated blood glucose levels. This is due to impaired insulin production by the inflamed pancreas. While serum amylase and lipase levels are typically elevated in acute pancreatitis, blood glucose levels are also affected due to the pancreatic dysfunction. Therefore, choices A and B are incorrect. Elevated calcium levels are not typically associated with acute pancreatitis, making choice D incorrect.

3. In orienting new staff nurses to a pediatric intensive care unit, what is an important consideration in providing information to parents of a critically ill child?

• A. Making sure they receive complete information during each encounter
• B. Assessing parents' preferences regarding the amount of information
• C. Allowing parents to observe key aspects of their child's care
• D. Providing patient education brochures explaining ICU protocols

Correct answer: B

Rationale: Assessing parents' preferences about the amount of information is crucial because it allows for individualized care that respects their needs and emotional capacity during a stressful time. Choice A is not ideal as overwhelming parents with complete information during each encounter may not align with their preferences. Choice C, while valuable, may not always be feasible or appropriate due to privacy concerns or medical procedures. Choice D, providing brochures, may not address the specific needs or preferences of each set of parents, making it less effective than assessing individual preferences.

4. A healthcare provider is preparing to administer a dose of clindamycin. Which of the following should the provider assess first?

• A. Allergy history
• B. Vital signs
• C. Renal function
• D. Liver function

Correct answer: A

Rationale: When preparing to administer clindamycin, assessing the patient's allergy history is crucial as clindamycin can cause severe allergic reactions. This assessment helps identify any potential risks related to allergies and enables the healthcare provider to take necessary precautions. Vital signs, renal function, and liver function are also important assessments before administering medications, but in this case, checking for any history of allergies takes priority due to the risk of severe allergic reactions associated with clindamycin.

5. A charge nurse is making assignments for the upcoming shift. What assignment should the charge nurse give to an LPN?

• A. A client who requires complex medication management
• B. A client who has dehydration and inflammatory bowel disease (IBD)
• C. A client needing assessment of a new diagnosis
• D. A client requiring a nursing care plan update

Correct answer: B

Rationale: The correct assignment for an LPN would be a client who has dehydration and inflammatory bowel disease (IBD). This choice is appropriate because it involves monitoring the client's condition, providing basic care, and assisting with activities of daily living, which align with the scope of practice for LPNs. Choices A, C, and D involve tasks that are more complex and require a higher level of nursing education and training, making them less suitable for an LPN.

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