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. How should a healthcare professional manage a patient with an indwelling urinary catheter?

• A. Monitor urine output and ensure proper drainage
• B. Administer antibiotics and change the catheter regularly
• C. Monitor for signs of infection and provide catheter care
• D. Provide high-sodium diet and monitor hydration

Correct answer: A

Rationale: Monitoring urine output and ensuring proper catheter drainage are crucial aspects of managing a patient with an indwelling urinary catheter. This helps in assessing the patient's renal function, fluid balance, and the patency of the catheter. Administering antibiotics and changing the catheter regularly (Choice B) may not be necessary unless there is an infection present. While monitoring for signs of infection and providing catheter care (Choice C) are important, the primary focus should be on urine output and drainage. Providing a high-sodium diet and monitoring hydration (Choice D) are not directly related to managing an indwelling urinary catheter.

3. What are the risk factors for the development of pressure ulcers, and how can they be prevented?

• A. Immobility and poor nutrition
• B. Increased mobility and proper hygiene
• C. Excess moisture and lack of movement
• D. Frequent turning and repositioning

Correct answer: A

Rationale: The correct answer is A: Immobility and poor nutrition are significant risk factors for pressure ulcers. Immobility leads to prolonged pressure on certain body areas, increasing the risk of tissue damage. Poor nutrition can impair skin integrity and the body's ability to heal. Prevention strategies include frequent turning and repositioning to relieve pressure points. Choice B is incorrect because increased mobility actually reduces the risk of pressure ulcers. Choice C is incorrect as excess moisture can contribute to skin breakdown, but it is not a primary risk factor. Choice D is incorrect as frequent turning and repositioning are part of the prevention measures, not risk factors.

4. A client with a tracheostomy is exhibiting signs of respiratory distress. What is the nurse's immediate priority?

• A. Increase the oxygen flow rate
• B. Suction the tracheostomy
• C. Notify the physician immediately
• D. Administer a bronchodilator

Correct answer: B

Rationale: When a client with a tracheostomy is experiencing respiratory distress, the immediate priority for the nurse is to suction the tracheostomy. This action helps clear the airway of secretions and ensures that the client can breathe effectively. Increasing the oxygen flow rate may be necessary but addressing the airway obstruction is more critical. Notifying the physician immediately is important but may cause a delay in addressing the immediate need for airway clearance. Administering a bronchodilator may help with bronchospasm but should not take precedence over ensuring a clear airway in a client with respiratory distress.

5. During an initial assessment of a client, a nurse notices a discrepancy between the client's current IV infusion and the information received during the shift report. Which of the following actions should the nurse take?

• A. Complete an incident report and place it in the client's medical record.
• B. Compare the current infusion with the prescription in the client's medication record.
• C. Contact the charge nurse to see if the prescription was changed.
• D. Submit a written warning for the nurse involved in the incident.

Correct answer: B

Rationale: The correct action for the nurse to take when noticing a discrepancy between the client's current IV infusion and the information received during the shift report is to compare the current infusion with the prescription in the client's medication record. This step is crucial to ensure the accuracy of the prescribed treatment and to prevent any potential harm to the client. Option A is incorrect because completing an incident report should only be done after verifying the discrepancy. Option C is incorrect as contacting the charge nurse should come after confirming the details. Option D is incorrect as submitting a written warning is not appropriate without verifying the information first.

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