Nursing Elites

1. When documenting in the client’s record, what type of information should be recorded?

• A. educated predictions of outcomes
• B. personal opinions
• C. objective information
• D. subjective information

Correct answer: C

Rationale: When documenting in a client's record, it is crucial to record objective information. Objective information is factual, based on observations and measurable data. This type of information is essential for accurate and effective communication among healthcare professionals involved in the client's care. Choices A and B, educated predictions of outcomes and personal opinions, are subjective in nature and may not provide an accurate representation of the client's condition. Choice D, subjective information, includes personal feelings, interpretations, and opinions, which are not ideal for documentation as they can be biased and unreliable.

2. What is the most appropriate feeding method for a client who is unable to swallow?

• A. Nothing by mouth
• B. Nasogastric feedings
• C. Clear liquids
• D. Total parenteral nutrition

Correct answer: B

Rationale: Nasogastric feedings are the most appropriate feeding method for a client who is unable to swallow. Providing nothing by mouth can lead to nutritional deficiencies, while clear liquids might cause aspiration. Total parenteral nutrition is not necessary if the gastrointestinal tract is functional. Nasogastric feedings are preferred as they can safely provide nutrition without the risks associated with not eating or aspirating.

3. A small amount of bubbling is seen in the water seal of a pleural drainage system when a client coughs. What should the nurse do?

• A. Consider it a normal finding.
• B. Check the system for leaks.
• C. Clamp the chest tube.
• D. Change the drainage system.

Correct answer: A

Rationale: A small amount of bubbling is a normal finding in the water seal of a pleural drainage system when a client coughs. It is only a problem to find continuous, excessive bubbling in the water seal, which indicates a leak. Checking the system for leaks would be appropriate if there is continuous, excessive bubbling. Clamping the chest tube or changing the drainage system is not necessary in response to a small amount of bubbling during a cough, as this is considered a normal finding.

4. For which of the following conditions might blood be drawn to assess uric acid levels?

• A. asthma
• B. gout
• C. diverticulitis
• D. meningitis

Correct answer: B

Rationale: Uric acid levels are commonly assessed in patients with gout. Gout is a type of arthritis caused by the buildup of uric acid crystals in the joints, leading to inflammation and pain. Monitoring uric acid levels helps in diagnosing and managing gout. Asthma, diverticulitis, and meningitis are not conditions where blood tests for uric acid levels are typically necessary. Asthma is a respiratory condition, diverticulitis involves inflammation of the digestive tract, and meningitis is an infection of the meninges in the brain and spinal cord.

5. An LPN on a Continuous Quality Improvement (CQI) team is tasked with implementing strategies to reduce medication errors. Which of the following strategies would be most beneficial for the LPN to implement?

• A. Track individuals who commit medication errors and report them to administration.
• B. Remind staff of the five rights of medication administration.
• C. Ensure that all staff members are proficient in completing incident reports if a medication error occurs.
• D. Double-check that staff document medication administration in the electronic medical record.

Correct answer: C

Rationale: The most beneficial strategy for the LPN on a CQI team to implement is to ensure that all staff members are proficient in completing incident reports if a medication error occurs. Organized and accurate incident reports are crucial in tracking and understanding why errors occurred. CQI teams utilize incident reports to develop new policies or enhance existing ones to standardize medical processes and reduce errors. Tracking individuals with medication errors (Choice A) may create a culture of blame rather than focusing on system improvements. Reminding staff of the five rights of medication administration (Choice B) is important for knowledge reinforcement but does not directly address the process improvement aspect. Double-checking documentation in the electronic medical record (Choice D) is necessary for accuracy but does not provide the detailed insights obtained from incident reports for process improvement.

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