Nursing Elites

1. A nurse working the 7 a.m. to 3 p.m. shift is reviewing the records of the assigned clients. Which client should the nurse assess first?

• A. A client scheduled for hemodialysis at 10 a.m.
• B. A client scheduled for contrast computed tomography (CT) at noon.
• C. A client scheduled for a nuclear scanning procedure at 10 a.m.
• D. A client scheduled for hydrotherapy for the treatment of a burn injury at 10:30 a.m.

Correct answer: A

Rationale: The correct answer is the client scheduled for hemodialysis at 10 a.m. This client needs immediate assessment before the procedure, which may take up to 5 hours. The nurse should ensure the client is physically and emotionally prepared, check for fluid overload by assessing weight and lung sounds, review vital signs, and laboratory test results. The other clients described in the options have needs that are not as urgent. The client scheduled for a nuclear scanning procedure at 10 a.m. may require information reinforcement and increased fluid intake before the procedure. The client scheduled for hydrotherapy for the treatment of a burn injury at 10:30 a.m. may need pain medication administered 30 minutes prior to the therapy. The client scheduled for a contrast CT at noon may need procedure information reinforcement and a special contrast preparation just before the procedure.

2. A health care provider repeatedly asks a nurse to write his verbal prescriptions in his clients' charts after he makes his rounds. The nurse is uncomfortable with writing the prescriptions and explains this to the health care provider, but the health care provider tells the nurse that she will be reported if she does not write the prescriptions. How should the nurse manage this conflict?

• A. Stating to the health care provider, 'I don't really care whether you report me. I am not writing your prescriptions.'
• B. Fulfilling the health care provider's request
• C. Discussing the situation with the nurse manager
• D. Reporting the health care provider to the chief of medicine at the hospital

Correct answer: C

Rationale: When a conflict arises, it is most appropriate to try resolving the conflict directly. In this situation, the nurse has tried to explain why she is uncomfortable with the health care provider's request but has been unable to resolve the conflict. The nurse would then most appropriately use organizational channels of communication and discuss the issue with the nurse manager, who would then proceed to resolve the conflict. The nurse manager may attempt to discuss the situation with the health care provider or seek assistance from the nursing supervisor. Fulfilling the health care provider's request and writing the prescriptions in the clients' charts ignores the issue. Reporting the health care provider to the chief of medicine is inappropriate because the nurse should use the appropriate organizational channels of communication to resolve the conflict. Stating 'I don't really care whether you report me. I am not writing your prescriptions.' is an inappropriate statement and will result in further conflict between the nurse and health care provider.

3. When assessing a client with terminal cancer receiving a continuous intravenous infusion of morphine sulfate, what should the nurse check first?

• A. Temperature
• B. Respiratory status
• C. Pulse
• D. Urine output

Correct answer: B

Rationale: When assessing a client with terminal cancer receiving morphine sulfate via continuous intravenous infusion, the nurse's priority should be checking the client's respiratory status first. Morphine sulfate can lead to respiratory depression, emphasizing the need for close monitoring of breathing. While temperature, pulse, and urine output are all essential components of the assessment, ensuring adequate respiratory function takes precedence due to the potential risk of respiratory depression associated with morphine sulfate. Promptly assessing respiratory status enables early identification of any signs of respiratory distress or depression, allowing for immediate intervention if needed.

4. Which of the following neurological disorders is characterized by writhing, twisting movements of the face and limbs?

• A. epilepsy
• B. Parkinson's
• C. multiple sclerosis
• D. Huntington's chorea

Correct answer: D

Rationale: Huntington's chorea is a neurological disorder characterized by writhing, twisting movements of the face and limbs, known as chorea. Epilepsy is characterized by seizures, not writhing, twisting movements. Parkinson's disease presents with tremors, rigidity, and bradykinesia, not writhing, twisting movements. Multiple sclerosis affects the central nervous system but does not typically involve writhing, twisting movements. Therefore, the correct answer is Huntington's chorea as it specifically manifests with these characteristic movements.

5. A risk management program within a hospital is responsible for all of the following except:

• A. identifying risks.
• B. controlling financial loss due to malpractice claims.
• C. ensuring that staff follow their job descriptions.
• D. analyzing risks and trends to guide further interventions or programs.

Correct answer: C

Rationale: A risk management program within a hospital is responsible for identifying risks, controlling financial loss due to malpractice claims, and analyzing risks and trends to guide further interventions or programs. It is not responsible for ensuring that staff follow their job descriptions. Monitoring staff adherence to their job descriptions falls under the purview of departmental managers or supervisors. The primary focus of a risk management program is to assess, mitigate, and manage risks related to patient safety, quality of care, and financial implications, rather than overseeing staff job descriptions.

Similar Questions