Nursing Elites

1. The graduate licensed practical nurse is assigned to care for the client on ventilator support, pending organ donation. Which goal should receive priority?

• A. Maintain the client's systolic blood pressure at 70mmHg or greater
• B. Maintain the client's urinary output greater than 300cc per hour
• C. Maintain the client's body temperature above 33°F rectal
• D. Maintain the client's hematocrit below 30%

Correct answer: A

Rationale: When caring for a client on ventilator support pending organ donation, maintaining the systolic blood pressure at 70mmHg or greater is crucial to ensure a proper blood supply to the donor organ. This goal is a priority to maintain the viability of the organ for donation. Choices B, C, and D are incorrect because they are unnecessary and not directly related to the immediate goal of organ donation. Maintaining urinary output, body temperature, or hematocrit levels are not the primary concerns in this situation.

2. The nurse provides a postoperative client with an analgesic medication and darkens the room before the client goes to sleep for the night. The nurse's actions:

• A. help decrease stimuli from the cerebral cortex.
• B. stimulate hormonal changes in the brain.
• C. help the client's circadian rhythm.
• D. alert the hypothalamus in the brain.

Correct answer: A

Rationale: The nurse's actions of providing an analgesic medication and darkening the room aim to decrease stimuli from the cerebral cortex. Reduction of environmental stimuli, especially light and noise, from the cerebral cortex, which is an area of arousal, facilitates sleep. By decreasing input to this area, the client is more likely to fall asleep and stay asleep. Choices B, C, and D are incorrect because the scenario does not involve stimulating hormonal changes, influencing the circadian rhythm, or alerting the hypothalamus.

3. What instruction should a client who is about to undergo pelvic ultrasonography be given by a healthcare provider?

• A. "Urinate prior to the test."?
• B. "Have someone drive you home."?
• C. "Do not drink after midnight."?
• D. "Drink plenty of water."?

Correct answer: D

Rationale: The correct instruction for a client about to undergo pelvic ultrasonography is to 'Drink plenty of water.' A full bladder is required to serve as a landmark to define pelvic organs during the procedure. It is important to ensure the bladder is adequately filled. 'Urinate prior to the test' (Choice A) would not be appropriate as a full bladder is needed for better visualization. 'Have someone drive you home' (Choice B) is unnecessary as no sedation is given during the procedure, so the client can drive home on their own. 'Do not drink after midnight' (Choice C) is unrelated and not necessary for a pelvic ultrasonography examination.

4. A client with cirrhosis of the liver presents with ascites. The physician is to perform a paracentesis. For safety, the nurse should ask the client to:

• A. drink 1000 cc of fluid prior to the procedure to aid in fluid loss.
• B. eat foods low in fat.
• C. empty his bladder prior to the procedure.
• D. assume the prone position.

Correct answer: C

Rationale: When performing a paracentesis, the client must be sitting up to allow the fluid to settle in the lower abdomen. To prevent trauma to the bladder while inserting a needle to aspirate the fluid, the bladder must be empty. Choice A is incorrect as excessive fluid intake can make the procedure more difficult due to increased abdominal distension. Choice B is unrelated to the procedure of paracentesis. Choice D is incorrect as the client should be sitting up, not in the prone position, during the procedure.

5. People-related supervisory tasks include all of the following except:

• A. coaching
• B. encouraging
• C. target setting
• D. rewarding

Correct answer: C

Rationale: People-related supervisory tasks involve direct interaction with individuals performing the work. Coaching, encouraging, rewarding, evaluating, and facilitating are all part of these tasks as they focus on supporting and motivating employees. Target setting, on the other hand, is a task-centered responsibility that involves projecting goals or objectives to be accomplished. It focuses more on setting objectives and goals rather than directly interacting with individuals, making it the exception among the given choices.

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