Nursing Elites

1. The nurse is caring for a patient who is at risk for infection. Which action by the nurse indicates correct understanding about standard precautions?

• A. Teaches the patient about good nutrition.
• B. Disposes of an uncapped needle in the designated container.
• C. Wears eyewear when emptying the urinary drainage bag.
• D. Dons gloves when wearing artificial nails.

Correct answer: C

Rationale: The correct understanding of standard precautions includes wearing appropriate personal protective equipment to prevent exposure to body fluids. Wearing eyewear when emptying the urinary drainage bag is crucial as it protects the nurse's eyes from potential splashes of body fluids. Teaching the patient about good nutrition (Choice A) is important for overall health but is not directly related to standard precautions. Disposing of an uncapped needle correctly (Choice B) is part of safe needle handling but does not specifically relate to standard precautions. Donning gloves when wearing artificial nails (Choice D) is not a correct understanding of standard precautions, as artificial nails can harbor microorganisms and increase the risk of infection transmission.

2. A nurse is caring for a client who has heart failure and is prescribed furosemide. Which of the following outcomes indicates that the medication is effective?

• A. Improvement in visual acuity
• B. Decreased respiratory rate
• C. Weight loss of 1.36 kg (3 lb) in 24 hours
• D. Increased urinary output

Correct answer: D

Rationale: The correct answer is D. Increased urinary output is the desired outcome when administering furosemide to a client with heart failure. Furosemide is a diuretic that promotes the excretion of excess fluids from the body, which helps in reducing fluid overload, a common symptom of heart failure. Choices A, B, and C are not directly related to the action of furosemide in treating heart failure. Visual acuity improvement, decreased respiratory rate, and rapid weight loss are not typical indicators of furosemide effectiveness in managing heart failure.

3. A nurse manager notices a discrepancy in a nurse's narcotics record. What is the appropriate action?

• A. Ask the nurse for clarification about the record.
• B. Report the discrepancy to the pharmacy.
• C. Report the issue to the nurse manager immediately.
• D. Ignore the discrepancy as a clerical error.

Correct answer: B

Rationale: The appropriate action when a nurse manager notices a discrepancy in a nurse's narcotics record is to report the discrepancy to the pharmacy. Reporting such discrepancies is crucial to ensure accountability and patient safety. Choice A is incorrect because the nurse manager should not confront the nurse directly without proper investigation. Choice C is incorrect because reporting to the nurse manager may not address the issue effectively. Choice D is incorrect because ignoring the discrepancy can compromise patient safety and violates protocols.

4. A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding indicates the condition is worsening?

• A. Increased shortness of breath
• B. Decreased wheezing
• C. Productive cough with green sputum
• D. Slight increase in fatigue

Correct answer: A

Rationale: The correct answer is A: Increased shortness of breath. In COPD, worsening symptoms often include increased shortness of breath due to impaired lung function. This indicates a decline in respiratory status and the need for prompt intervention. Choice B, decreased wheezing, is not indicative of worsening COPD as it could suggest better airflow. Choice C, productive cough with green sputum, may indicate an infection but not necessarily worsening COPD. Choice D, a slight increase in fatigue, is non-specific and may not directly correlate with the worsening of COPD.

5. Which action should the nurse take to minimize the risk of medication errors?

• A. Prepare medications ahead of time to ensure they are ready.
• B. Ensure two nurses double-check medications before administration.
• C. Administer medications at the same time each day.
• D. Rely on memory to administer the correct medications.

Correct answer: B

Rationale: The correct answer is B because ensuring two nurses double-check medications before administration is a crucial step in minimizing the risk of medication errors. This practice helps in verifying the accuracy of medication orders and reducing the chances of mistakes. Choice A may not necessarily prevent errors as preparing medications ahead of time does not guarantee accuracy. Choice C, administering medications at the same time each day, is important for consistency but does not directly address the risk of errors. Choice D, relying on memory, is highly discouraged as it increases the likelihood of errors due to human forgetfulness.

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