Nursing Elites

1. An RN is making assignments for client care to an LPN at the beginning of the shift. Which of the following assignments should the LPN question?

• A. Assisting a client who is 24 hr postop to use an incentive spirometer
• B. Collecting a clean catch urine specimen from a client who was admitted on the previous shift
• C. Providing nasopharyngeal suctioning for a client who has pneumonia
• D. Replacing the cartridge and tubing on a PCA pump

Correct answer: D

Rationale: The LPN should question the assignment of replacing the PCA pump cartridge and tubing as it is outside the LPN's scope of practice. LPNs are not trained to handle tasks related to PCA pumps, which involve medication administration and monitoring that are typically within the RN's responsibilities. Assisting a postop client with an incentive spirometer (Choice A), collecting a clean catch urine specimen (Choice B), and providing nasopharyngeal suctioning for a client with pneumonia (Choice C) are all tasks that fall within the LPN's scope of practice and do not require questioning by the LPN.

2. A client has an NG tube that needs irrigation every 8 hours. Which solution should be used to irrigate the tube to maintain fluid and electrolyte balance?

• A. Tap water
• B. Sterile water
• C. 0.9% sodium chloride
• D. 0.45% sodium chloride

Correct answer: C

Rationale: The correct answer is 0.9% sodium chloride. This solution is isotonic and helps maintain electrolyte balance during irrigation, preventing fluid and electrolyte imbalances. Tap water (choice A) may cause electrolyte imbalances due to its hypotonic nature. Sterile water (choice B) is hypotonic and can lead to electrolyte disturbances. 0.45% sodium chloride (choice D) is hypotonic and may also disrupt electrolyte balance when used for irrigation.

3. A nurse is delegating the collection of a sputum specimen to an assistive personnel (AP). At which of the following times should the nurse instruct the AP to collect the specimen?

• A. In the afternoon
• B. As soon as the client awakens in the morning
• C. Before bedtime
• D. Immediately after lunch

Correct answer: B

Rationale: The correct answer is B: 'As soon as the client awakens in the morning.' Sputum specimens should be collected early in the morning to obtain a concentrated sample. This timing ensures that the specimen is less diluted, providing a more accurate analysis. Choices A, C, and D are incorrect as they do not align with the optimal timing for collecting a sputum specimen, which is in the morning.

4. A nurse is teaching a client who has hypertension about dietary modifications. Which of the following instructions should the nurse include?

• A. Increase sodium intake
• B. Reduce sodium intake to less than 1,500 mg per day
• C. Limit caffeine intake
• D. Increase caffeine intake to improve focus

Correct answer: B

Rationale: The correct answer is B: 'Reduce sodium intake to less than 1,500 mg per day.' For clients with hypertension, reducing sodium intake is crucial as it helps manage blood pressure. High sodium intake can lead to fluid retention and increased blood pressure. Choice A is incorrect because increasing sodium intake would worsen hypertension. Choice C is also correct as limiting caffeine intake is beneficial for managing hypertension. Choice D is incorrect as increasing caffeine intake can elevate blood pressure, which is detrimental for clients with hypertension.

5. A nurse is contributing to the plan of care for an older adult client who has difficulty sleeping. Which of the following interventions should the nurse include?

• A. Give a bedtime snack
• B. Encourage a short nap in the afternoon
• C. Encourage exercise right before bed
• D. Establish a regular exercise routine 2 hours or more before bedtime

Correct answer: D

Rationale: The correct answer is D. Establishing a regular exercise routine at least 2 hours before bedtime promotes better sleep in older adults. Giving a bedtime snack (choice A) may disrupt sleep due to digestion, encouraging a short nap in the afternoon (choice B) can interfere with nighttime sleep, and encouraging exercise right before bed (choice C) can increase alertness and make it harder to fall asleep.

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