Nursing Elites

1. Serge, who has diabetes mellitus, is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of action for the nurse regarding Serge's oral medications?

• A. Administer the oral agents immediately after the test.
• B. Notify the diagnostic department and request orders.
• C. Notify the physician and request orders.
• D. Administer the oral agents with a sip of water before the test.

Correct answer: C

Rationale: The best plan of action for the nurse is to notify the physician and request orders regarding Serge's oral medications. By involving the physician, the nurse ensures that appropriate instructions are obtained, considering Serge's medical condition and the need for NPO status for the diagnostic test. Administering the medications without medical guidance (choice A) can be risky, as it may affect the test results. Notifying the diagnostic department (choice B) is not the most direct and appropriate action; the physician is the primary healthcare provider responsible for medication orders. Administering the medications with water before the test (choice D) is not advisable when the patient is supposed to be NPO, as it can interfere with the test requirements.

2. A nurse in a prenatal clinic is caring for a group of clients. Which of the following clients should the nurse recommend for further evaluation and possible intervention?

• A. A client who is at 28 weeks gestation and has a negative Coombs titer
• B. A client who is 39 weeks of gestation and has a negative contraction stress test
• C. A client who is at 35 weeks of gestation and has a biophysical profile of 6
• D. A client who is at 37 weeks of gestation and has an L/S ratio of 2:1

Correct answer: C

Rationale: A biophysical profile of 6 at 35 weeks of gestation indicates a need for further evaluation and possible intervention. A negative Coombs titer at 28 weeks gestation (Choice A) is within normal limits. A negative contraction stress test at 39 weeks gestation (Choice B) is expected as the pregnancy nears term. An L/S ratio of 2:1 at 37 weeks of gestation (Choice D) is consistent with fetal lung maturity.

3. A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the following actions should the nurse take first?

• A. Discuss time management strategies with the nurses
• B. Provide coverage for the nurses' breaks
• C. Determine the reasons the nurses are not taking scheduled breaks
• D. Review policies for taking scheduled breaks

Correct answer: C

Rationale: The correct answer is to determine the reasons the nurses are not taking scheduled breaks. This action is crucial as it allows the charge nurse to understand the underlying causes for the behavior. By identifying the reasons, the nurse can then address the root of the issue effectively. Option A is incorrect because discussing time management strategies may not address the specific reasons for not taking breaks. Option B is incorrect as providing coverage for breaks does not address the underlying cause of the issue. Option D is also incorrect as reviewing policies should come after understanding the reasons for the behavior.

4. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse make before delegating care?

• A. Is the client's family present so the AP can show them how to turn the client?
• B. Has data been collected about specific client needs related to turning?
• C. Does the AP have time to change the client's central IV line dressing after turning her?
• D. Has the AP checked the client's pain level prior to turning her?

Correct answer: B

Rationale: Before delegating the task of bathing and turning a client with end-stage cancer to an experienced assistive personnel (AP), the nurse must assess specific client needs related to turning. This assessment ensures that the delegated care is tailored to the client's individual requirements, promoting safe and effective care. Option A is incorrect because the presence of the client's family is not directly related to assessing the client's specific needs for turning. Option C is incorrect as it refers to a different task (changing the central IV line dressing) and is not directly related to the turning assessment. Option D is incorrect as checking the client's pain level, although important, is not directly related to the specific needs related to turning the client.

5. When developing an educational program for staff regarding a new intravenous pump, what is the correct sequence of actions for a nurse to take?

• A. Develop learning objectives for the program
• B. Identify what skills to teach the staff members
• C. Conduct program evaluation with staff members
• D. Schedule several sessions of the program

Correct answer: B

Rationale: The correct sequence of actions when developing an educational program for staff regarding a new intravenous pump is to first identify what skills to teach the staff members. This step is essential as it sets the foundation for the learning objectives to be developed next. Once the learning objectives are established, scheduling several sessions of the program can be planned accordingly. Finally, after the program has been conducted, program evaluation with staff members should take place to assess the effectiveness of the educational program. Therefore, options A, C, and D are out of sequence, making them incorrect choices.

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