Nursing Elites

1. When resolving a conflict, which statement made by the charge nurse is an example of smoothing?

• A. You have been a nurse a long time, so I’m sure you’re capable of the tasks.
• B. If you prefer, I can take over your assignment.
• C. We can switch your assignment with someone else.
• D. Let’s discuss your concerns in a private setting.

Correct answer: A

Rationale: The correct answer is A because it exemplifies smoothing, a conflict resolution strategy where the charge nurse reassures the staff nurse of their capabilities. Choice B offers to take over the assignment, which is more of a compromising strategy. Choice C suggests switching assignments, which aligns with compromising rather than smoothing. Choice D proposes a discussion in a private setting, indicating a collaborating approach rather than smoothing.

2. A nurse is preparing to administer total parenteral nutrition (TPN) to a client. Which of the following findings indicates a need to obtain a new bag of TPN before administering?

• A. The TPN solution has an oily appearance and a layer of fat on top of the solution.
• B. The TPN solution contains added electrolytes, vitamins, and trace elements.
• C. The bag of TPN was prepared by the pharmacy 12 hours prior.
• D. The bag of TPN is labeled with the client's name, medical record number, and prescription.

Correct answer: A

Rationale: A TPN solution with an oily appearance and a layer of fat on top indicates that the solution is 'cracked' and should not be used as it may have separated or deteriorated. This finding suggests a need to obtain a new bag of TPN before administering. Options B, C, and D are normal aspects of TPN administration. Option B confirms the presence of essential components in the TPN solution, option C provides information about the preparation time, and option D ensures proper identification and matching of the TPN with the correct client.

3. A client has a new prescription for metformin. Which of the following should the nurse educate the client about?

• A. It can cause weight gain
• B. It should be taken with meals
• C. It is an injectable medication
• D. It can cause hypoglycemia

Correct answer: B

Rationale: The correct answer is B: 'It should be taken with meals.' Metformin should be taken with meals to minimize gastrointestinal side effects and improve absorption. Choice A is incorrect because metformin is actually associated with weight loss or weight neutrality. Choice C is incorrect as metformin is typically taken orally and not via injection. Choice D is also incorrect because metformin is not known to cause hypoglycemia as a primary side effect.

4. A nurse is planning care for a client who has a chest tube. Which of the following actions should the nurse take to ensure proper functioning of the chest tube?

• A. Clamp the chest tube intermittently.
• B. Keep the drainage system below chest level.
• C. Empty the drainage chamber every 4 hours.
• D. Apply sterile gauze around the insertion site daily.

Correct answer: B

Rationale: To ensure proper functioning of a chest tube, the nurse should keep the drainage system below chest level. This position allows for proper drainage by gravity and prevents backflow into the pleural space. Clamping the chest tube intermittently can lead to a buildup of pressure and should be avoided. Emptying the drainage chamber every 4 hours is important but not directly related to maintaining the chest tube's function. Applying sterile gauze around the insertion site daily is essential for infection prevention but does not specifically ensure the proper functioning of the chest tube.

5. A nurse is caring for a client prescribed metoprolol. Which of the following should the nurse monitor for as an adverse effect of this medication?

• A. Bradycardia
• B. Hypotension
• C. Tachycardia
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is B: Hypotension. Metoprolol, a beta-blocker, can lead to a decrease in blood pressure, resulting in hypotension. Monitoring blood pressure regularly is essential to detect and manage this adverse effect. Choices A, C, and D are incorrect because metoprolol typically does not cause bradycardia, tachycardia, or hyperglycemia as its primary adverse effects.

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