Nursing Elites

1. A nurse on a rehabilitation unit is creating a plan of care for a newly admitted client who has difficulty swallowing following a stroke. Which of the following inter-professional team members should the nurse anticipate consulting regarding the client's condition?

• A. Speech-language pathologist
• B. Occupational therapist
• C. Dietitian
• D. Pharmacy technician

Correct answer: A

Rationale: The correct answer is A, Speech-language pathologist. A speech-language pathologist specializes in evaluating and treating swallowing difficulties, known as dysphagia, which commonly occurs following a stroke. They are experts in developing strategies to help individuals improve their ability to swallow safely. Occupational therapists (B) focus on helping individuals regain independence in activities of daily living, not specifically addressing swallowing concerns. Dietitians (C) primarily work on developing appropriate nutrition plans but may not directly address swallowing issues. Pharmacy technicians (D) assist pharmacists in dispensing medications and are not directly involved in managing swallowing difficulties.

2. A charge nurse on a medical-surgical unit is preparing to delegate tasks to a licensed practical nurse (LPN). Which of the following tasks should the charge nurse delegate to the LPN?

• A. Administering an oral antibiotic to a client
• B. Performing an admission assessment of a client
• C. Creating new teaching for a guardian of a toddler
• D. Administering IV conscious sedation to a client

Correct answer: A

Rationale: Administering oral antibiotics is within the scope of practice for an LPN and can be safely delegated. LPNs are trained to administer medications, including oral ones. Performing an admission assessment (Choice B) involves critical thinking and comprehensive evaluation, typically done by registered nurses. Creating new teaching material (Choice C) requires specialized knowledge and is usually the responsibility of a nurse with additional training in education. Administering IV conscious sedation (Choice D) is a high-risk task that requires advanced skills and should be performed by a registered nurse or higher-level provider.

3. A nurse manager is implementing a quality improvement project to reduce the number of methicillin-resistant Staphylococcus aureus (MRSA) infections at the facility. Which of the following actions should the nurse manager take first?

• A. Develop an MRSA protocol for implementation.
• B. Provide educational in-services for staff.
• C. Evaluate outcomes resulting from interventions.
• D. Conduct a chart review to evaluate precipitating factors of clients who develop MRSA.

Correct answer: D

Rationale: Conducting a chart review to evaluate the precipitating factors of clients who develop MRSA is the initial step in reducing these infections. By identifying factors contributing to MRSA infections, the nurse manager can develop targeted interventions. Developing an MRSA protocol (choice A) and providing educational in-services (choice B) would be premature without understanding the specific factors at play. Evaluating outcomes (choice C) should come after implementing interventions based on the findings from the chart review.

4. What is the most important action for the nurse to take before administering digoxin to a patient?

• A. Check the patient's heart rate before administration.
• B. Assess the patient's blood pressure before administration.
• C. Ensure the patient has eaten before administration.
• D. Monitor the patient's weight before administration.

Correct answer: A

Rationale: The correct answer is to check the patient's heart rate before administering digoxin. Digoxin is a medication that primarily affects cardiac function. Monitoring the heart rate is crucial because digoxin can cause arrhythmias or worsen existing heart rhythm abnormalities. Assessing blood pressure may also be important but is secondary to evaluating the heart rate when administering digoxin. Ensuring the patient has eaten before administration is not directly related to the safe administration of digoxin. Monitoring the patient's weight is not a priority action before administering digoxin.

5. A client just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

• A. Irrigate the client's throat every 4 hours
• B. Withhold food and liquids until the client's gag reflex returns
• C. Suction the client's oropharynx frequently
• D. Have the client refrain from talking for 24 hours

Correct answer: B

Rationale: After a flexible bronchoscopy, it is essential to withhold food and liquids until the client's gag reflex returns. This precaution helps prevent aspiration, as the gag reflex protects the airway from foreign material. Irrigating the client's throat every 4 hours (Choice A) is unnecessary and may increase the risk of aspiration. Suctioning the client's oropharynx frequently (Choice C) can cause trauma and is not indicated unless there is a specific medical reason for it. Having the client refrain from talking for 24 hours (Choice D) is not necessary after a flexible bronchoscopy.

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