Nursing Elites

1. As a nurse, you have been assigned to take over as charge nurse without any report after the previous charge nurse fell during her shift and was taken to the emergency room. At the end of the shift, you have made the assignments for the next shift's nurses and posted them. As the nurses come in, they begin to complain that the assignments make no sense based on patient acuity. One refuses to take her assignment and threatens to go home. What could you have done to prevent their dissatisfaction?

• A. Reviewed the notes of the previous charge nurse
• B. Tried to contact the previous charge nurse in the emergency room
• C. Collaborated with the nurse manager
• D. Collaborated with the other nurses on your shift

Correct answer: D

Rationale: Collaborating with the other nurses on your shift would have permitted them to provide the most updated information regarding patient status and acuity. Requesting their input into creating assignments would have provided shared governance and assurance that the unit staffing was arranged appropriately. Reviewing the notes of the previous charge nurse might not capture the real-time changes in patient conditions. Trying to contact the previous charge nurse in the emergency room may not be feasible or timely. Collaborating with the nurse manager could be helpful, but involving the nurses directly impacted by the assignments would have been more effective in addressing their concerns and ensuring appropriate patient care.

2. You are creating a teaching plan for a patient with newly diagnosed migraine headaches. Which key item should NOT be included in the teaching plan?

• A. Avoid foods that contain tyramine, such as alcohol and aged cheese.
• B. Avoid drugs such as Tagamet, nitroglycerin, and Nifedipine.
• C. Continue taking estrogen as prescribed by your physician.
• D. A potential side effect of medications is rebound headache.

Correct answer: C

Rationale: The correct answer is C: Continue taking estrogen as prescribed by your physician. Medications such as estrogen supplements may actually trigger a migraine headache attack. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy, and menopause, seem to trigger headaches in many women. Choices A and B are important to include in the teaching plan for a patient with migraines as avoiding foods containing tyramine and certain drugs can help prevent migraine triggers. Choice D is also relevant as it is essential for the patient to be aware of potential side effects of medications, including rebound headaches.

3. A healthcare professional is preparing to insert an indwelling catheter in a female client. Which of the following positions of the client is most appropriate for this procedure?

• A. Lithotomy position
• B. Prone position
• C. Dorsal recumbent position
• D. High Fowler's position

Correct answer: C

Rationale: When preparing to insert an indwelling catheter for a female client, the most appropriate position is the dorsal recumbent position. In this position, the client lies on their back with knees bent. This position allows for easy access to the urethral area for catheter insertion. The lithotomy position, with legs elevated and spread apart, is more invasive and typically used for gynecological exams. The prone position, lying face down, is not suitable for catheter insertion. High Fowler's position, sitting upright at a 90-degree angle, is not ideal for catheter insertion as it does not provide proper access to the perineal area.

4. A 31-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate?

• A. MS symptoms may be worse after the pregnancy
• B. Women with MS frequently have premature labor
• C. MS is associated with an increased risk for congenital defects
• D. Symptoms of MS are likely to become worse during pregnancy

Correct answer: A

Rationale: After pregnancy, women with MS are at higher risk for exacerbation of symptoms due to the postpartum period. There is no increased risk for congenital defects in infants born to mothers with MS. Symptoms of MS may actually improve during pregnancy, likely due to hormonal changes. MS does not significantly impact the onset of labor. Therefore, the correct response is that MS symptoms may worsen after pregnancy, making option A the accurate answer. Options B, C, and D are incorrect as they do not accurately reflect the risks associated with pregnancy in individuals with MS.

5. The priority goal for a family who practices Chinese medicine would be to:

• A. Achieve harmony
• B. Maintain a balance of energy
• C. Respect life
• D. Restore yin and yang

Correct answer: D

Rationale: In Chinese medicine, the concept of yin and yang represents the balance of opposing forces in the body. When there is an imbalance between yin and yang, it can result in illness. Therefore, the priority goal for a family practicing Chinese medicine would be to restore the harmony and balance between yin and yang. Choices A, B, and C are not the priority goal in Chinese medicine. While achieving harmony, maintaining a balance of energy, and respecting life are important aspects of Chinese medicine, the fundamental principle revolves around maintaining the equilibrium of yin and yang for optimal health.

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