Nursing Elites

1. A staff nurse is challenging a shift assignment with the charge nurse. Which of the following statements made by the charge nurse is an example of smoothing as a strategy to resolve conflict?

• A. If you accept this assignment today, I will let you choose your assignment tomorrow
• B. If you don't agree with the assignment, I will have to report your decision to the nursing supervisor
• C. Let's just focus on giving our client medications on time
• D. You have a lot of experience, so I'm sure you're capable of these tasks

Correct answer: D

Rationale: The correct answer is D because it exemplifies smoothing as a conflict resolution strategy. Smoothing involves downplaying conflict and reassuring the individual to reduce tension. In this statement, the charge nurse acknowledges the staff nurse's experience and capability to perform the assigned tasks, which aims to reduce conflict and promote a positive outlook. Choices A, B, and C do not reflect smoothing. Choice A involves a conditional agreement, choice B introduces a threat of reporting, and choice C shifts the focus away from the conflict.

2. A healthcare provider notices a discrepancy in the narcotics log. What is the appropriate response?

• A. Correct the narcotics log and move on.
• B. Report the discrepancy to the supervisor.
• C. Confront the provider responsible for the discrepancy.
• D. Dispose of the medication and ignore the discrepancy.

Correct answer: B

Rationale: When a healthcare provider notices a discrepancy in the narcotics log, the appropriate response is to report the issue to the supervisor. Reporting discrepancies is crucial to maintain accountability and prevent potential misuse. Choice A is incorrect because simply correcting the log without addressing the underlying issue does not ensure accountability. Choice C is inappropriate as confronting the provider directly may not be the best approach and could lead to a confrontational situation. Choice D is highly inappropriate as ignoring the discrepancy and disposing of medication without proper documentation can lead to serious consequences.

3. A healthcare professional is teaching a patient how to prevent falls at home. Which instruction is most appropriate?

• A. Keep your living space well-lit.
• B. Remove loose rugs and install grab bars in the bathroom.
• C. Use furniture to provide support when walking.
• D. Wear socks without shoes to prevent slipping.

Correct answer: B

Rationale: The most appropriate instruction to prevent falls at home is to remove loose rugs and install grab bars in high-risk areas like the bathroom. This helps eliminate tripping hazards and provides stability for the patient. Keeping the living space well-lit (Choice A) is important but may not directly address fall prevention. Using furniture for support (Choice C) can lead to accidents if the furniture is not stable. Wearing socks without shoes (Choice D) increases the risk of slipping rather than preventing falls.

4. A nurse is preparing to administer medications to four clients. The nurse should administer medications to which client first?

• A. A client who has pneumonia and a WBC count of 11,500/mm3 prescribed piperacillin
• B. A client who has renal failure and a serum potassium of 5.8 mEq/L prescribed sodium polystyrene sulfonate
• C. A client who is post-coronary artery bypass graft (CABG) prescribed atorvastatin
• D. A client who has anemia and a hemoglobin level of 11g/dL prescribed epoetin alfa

Correct answer: B

Rationale: The correct answer is B. The client with renal failure and high potassium levels requires immediate attention because hyperkalemia can lead to life-threatening cardiac complications. Administering sodium polystyrene sulfonate helps lower the potassium levels. Choice A, the client with pneumonia and a high WBC count, although important, does not present an immediate life-threatening condition. Choice C, the post-CABG client prescribed atorvastatin, and Choice D, the client with anemia and a hemoglobin level of 11g/dL prescribed epoetin alfa, do not require immediate intervention compared to managing hyperkalemia in a client with renal failure.

5. A nurse manager is planning client assignments for the day. Which client should the nurse assign to the nursing assistant?

• A. A client who needs help ambulating.
• B. A client who requires complex wound care.
• C. A client who needs intravenous antibiotics.
• D. A client who is NPO and requires IV hydration.

Correct answer: A

Rationale: The correct answer is A because ambulating a client is a non-invasive task that can be safely and effectively performed by a nursing assistant. Choice B is incorrect as complex wound care requires specialized skills usually performed by licensed nurses. Choice C involves administering intravenous antibiotics, which also requires a higher level of training and assessment skills than a nursing assistant possesses. Choice D, involving a client who is NPO and requires IV hydration, may involve further assessments and monitoring that are beyond the scope of a nursing assistant.

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