Nursing Elites

1. A nurse overhears a colleague informing a client that he will administer her medication by injection if she refuses to swallow her pills. The nurse should recognize that the colleague is committing which of the following torts?

• A. Defamation - harming someone's reputation through false statements.
• B. Malpractice - professional negligence or misconduct.
• C. Assault - threatening to cause harm to someone.
• D. Battery - intentional harmful or offensive physical contact.

Correct answer: C

Rationale: In this scenario, the colleague's action of informing the client that he will administer medication by injection if she refuses to swallow her pills constitutes assault. Assault is the act of threatening harm that causes fear of imminent harm. It does not involve physical contact but rather the apprehension of an imminent harmful or offensive act. Defamation, choice A, is incorrect as it involves harming someone's reputation through false statements. Malpractice, choice B, is also incorrect as it refers to professional negligence or misconduct in performing duties. Battery, choice D, is not the correct answer as it involves intentional harmful or offensive physical contact with the person.

2. A nurse is providing teaching to an older adult client about home safety. Which of the following information should the nurse include?

• A. “Keep a nightlight on in the bathroom”
• B. “Set room temperature to 68 degrees Fahrenheit”
• C. “Place throw rugs over electrical cords”
• D. “Use chairs without armrests”

Correct answer: A

Rationale: The correct answer is A: 'Keep a nightlight on in the bathroom.' This safety measure is crucial for older adults to prevent falls by enhancing visibility during nighttime bathroom visits. Choice B is incorrect because setting the room temperature to 68 degrees Fahrenheit may not be universally suitable for all older adults, as individual preferences vary. Choice C is incorrect as placing throw rugs over electrical cords poses a tripping hazard rather than enhancing safety. Choice D is incorrect as using chairs without armrests may not provide adequate support and stability for older adults, increasing the risk of falls.

3. A client with diabetes mellitus and a new prescription for insulin is being discharged. Which of the following actions should the nurse plan to complete first?

• A. Provide the client with printed information on insulin self-administration.
• B. Obtain printed information on insulin self-administration.
• C. Make a copy of the medication reconciliation form for the client.
• D. Determine whether the client can afford the insulin administration supplies.

Correct answer: B

Rationale: Obtaining printed information on insulin self-administration should be the nurse's first priority. This action ensures that the client has the necessary knowledge to safely self-administer insulin at home. Providing the client with printed information (Choice A) is essential to empower the client with the required knowledge before considering additional resources. Making a copy of the medication reconciliation form for the client (Choice C) is important for documentation purposes but not as urgent as ensuring the client's understanding of insulin administration. Determining the client's ability to afford insulin administration supplies (Choice D) is crucial but should follow after ensuring the client is equipped with the necessary information for safe self-administration.

4. The nurse is teaching an elderly client how to use MDIs (multi-dose inhalers). The nurse is concerned that the client is unable to coordinate the release of the medication with the inhalation phase. What is the nurse's best recommendation to improve the delivery of the medication?

• A. Nebulized treatments for home care
• B. Adding a spacer device to the MDI canister
• C. Asking a family member to assist the client with the MDI
• D. Requesting a visiting nurse to follow the client at home

Correct answer: B

Rationale: Adding a spacer device to the MDI canister is the best recommendation in this scenario. The spacer device helps to improve coordination and medication delivery by allowing the client more time to inhale the medication effectively. Nebulized treatments for home care (Choice A) involve a different delivery method and are not directly related to improving coordination with MDIs. Asking a family member to assist (Choice C) may not address the core issue of coordination between releasing the medication and inhalation. Requesting a visiting nurse (Choice D) may not be necessary if the client can improve coordination with the spacer device.

5. When preparing an injection for opioid medication, a nurse draws 1mL from a 2mL vial. What should the nurse do next?

• A. Ask another nurse to observe medication wastage
• B. Document the amount of medication drawn on the MAR
• C. Dispose of the remaining medication in a sharps container
• D. Administer the entire vial of medication to avoid wastage

Correct answer: A

Rationale: When drawing medication from a vial, especially for controlled substances like opioids, any wastage must be witnessed by another healthcare professional to ensure accuracy, prevent diversion, and maintain safety standards. This process is crucial for proper documentation and accountability. Recording the amount drawn on the Medication Administration Record (MAR) is important for tracking administered doses and preventing errors. Disposing of the remaining medication in a sharps container is not recommended as it does not address proper wastage documentation. Administering the entire vial of medication just to avoid wastage is inappropriate and can lead to potential harm or overdose in the patient.

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