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. To reduce the incidence of sudden infant death syndrome (SIDS), how should the parents position the newborn?

• A. Prone position
• B. Supine position
• C. Side-lying position
• D. Semi-Fowler's position

Correct answer: B

Rationale: The correct answer is B: Supine position. Placing the newborn on their back (supine position) is the safest sleeping position to reduce the risk of sudden infant death syndrome (SIDS). This position helps prevent airway obstruction, which can occur when infants are placed on their stomach (prone position), side (side-lying position), or in a semi-upright position (semi-Fowler's position). The prone position (choice A) is associated with an increased risk of SIDS, making it an unsafe choice. Side-lying position (choice C) and semi-Fowler's position (choice D) also pose risks of airway compromise and are not recommended for sleep positioning to prevent SIDS. Therefore, options A, C, and D are incorrect in this context.

3. A nurse is caring for four clients. Which client should the nurse assess first?

• A. A client scheduled to receive chemotherapy for the first time
• B. A client post-appendectomy with diminished bowel sounds
• C. A client with hypothyroidism who is stuporous
• D. A client with burns requiring a sterile dressing change

Correct answer: C

Rationale: The correct answer is C. The client with hypothyroidism who is stuporous should be assessed first as this may indicate a critical condition, possibly related to severe hypothyroidism. Stupor is a state of near-unconsciousness or insensibility, suggesting a decline in neurological function that requires immediate evaluation. Choices A, B, and D do not present with immediate life-threatening conditions that require urgent assessment. While chemotherapy, post-appendectomy complications, and burn care are important, they do not pose the same level of immediate risk as a stuporous client.

4. A client with chronic kidney disease is being educated by a nurse about managing their condition. Which of the following statements shows an understanding of the teaching?

• A. I will need to take an iron supplement.
• B. I will consume foods high in phosphorus.
• C. I will reduce my intake of carbohydrates.
• D. I will monitor my blood glucose level daily.

Correct answer: A

Rationale: The correct answer is A. Clients with chronic kidney disease often develop anemia due to reduced erythropoietin production, leading to decreased red blood cell production. Iron supplementation is frequently required to enhance red blood cell production. Choices B, C, and D are incorrect because in chronic kidney disease, there is a need to restrict phosphorus intake, control carbohydrate intake for blood sugar management, and monitor electrolytes and fluid balance rather than blood glucose levels.

5. A client with HIV and neutropenia requires specific care from the nurse. Which of the following precautions should the nurse take while caring for this client?

• A. Wear an N95 respirator while caring for the client.
• B. Use a dedicated stethoscope for the client.
• C. Insert an indwelling urinary catheter to monitor urinary output.
• D. Monitor the client’s vital signs every 8 hours.

Correct answer: B

Rationale: Using dedicated equipment for a neutropenic client, such as a stethoscope, helps prevent infections. Neutropenic clients have a weakened immune system, making them vulnerable to infections from common pathogens. Wearing an N95 respirator is not necessary unless airborne precautions are required. Inserting a urinary catheter should be avoided unless necessary to prevent introducing pathogens. Monitoring vital signs should be done more frequently, typically every 4 hours, to promptly identify any changes in the client's condition.

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