Nursing Elites

1. Which therapeutic technique is recommended for clients with somatic symptom disorder?

• A. Encourage complete bed rest
• B. Limit the amount of time the client spends discussing symptoms
• C. Monitor the client's food intake
• D. Educate the client on lifestyle changes to reduce symptoms

Correct answer: B

Rationale: The correct therapeutic technique recommended for clients with somatic symptom disorder is to limit the amount of time the client spends discussing symptoms. By doing so, the focus can be shifted away from the illness, helping the client to manage their condition better. Encouraging complete bed rest (Choice A) is not typically recommended as it may reinforce illness behaviors. Monitoring the client's food intake (Choice C) may not directly address the psychological aspects of somatic symptom disorder. Educating the client on lifestyle changes (Choice D) is important but may not be as effective initially as limiting symptom-focused discussions.

2. A nurse manager is asked to select clients for early discharge from the unit following a mass casualty event. Which of the following clients should the nurse manager recommend?

• A. A client awaiting a screening colonoscopy later that day
• B. A client whose discharge was cancelled the prior day because they developed respiratory distress
• C. A client who is 6 hr postoperative following an open cholecystectomy
• D. A client who is prescribed gastric lavage treatments to treat acute aspirin toxicity

Correct answer: A

Rationale: The nurse manager should recommend the client awaiting a screening colonoscopy later that day for early discharge following a mass casualty event. This client is stable and not in immediate need of hospital care. Choices B, C, and D involve clients who require ongoing monitoring and care due to recent developments or treatments, making them unsuitable for early discharge during a mass casualty event.

3. A client with a DNR order has requested resuscitation during a visit from the family. What is the nurse's best course of action?

• A. Follow the family's request and perform CPR.
• B. Explain to the family that the DNR must be honored.
• C. Call the healthcare provider to cancel the DNR order.
• D. Delay resuscitation until further clarification can be made.

Correct answer: B

Rationale: The correct course of action for the nurse is to explain to the family that the DNR (Do Not Resuscitate) order must be honored. It is essential for the nurse to uphold the client's wishes as documented in the DNR order. Performing CPR against the client's expressed wishes in the DNR order would violate ethical and legal standards. Calling the healthcare provider to cancel the DNR order without the client's consent is inappropriate and goes against the client's autonomy. Delaying resuscitation can be detrimental in an emergency situation and may not align with the client's wishes as outlined in the DNR order.

4. What intervention should the nurse implement for a patient receiving a blood transfusion?

• A. Administer antihistamines to prevent allergic reactions.
• B. Monitor the patient for signs of circulatory overload.
• C. Ensure the blood transfusion is completed within 4 hours.
• D. Check the patient's vital signs every 30 minutes during the transfusion.

Correct answer: B

Rationale: The correct intervention for a patient receiving a blood transfusion is to monitor the patient for signs of circulatory overload. This is crucial to prevent fluid overload, which can lead to serious complications. Administering antihistamines is not a routine intervention during blood transfusions unless the patient shows signs of an allergic reaction. Ensuring the completion of the blood transfusion within a specific time frame is not as critical as monitoring for circulatory overload. Checking vital signs every 30 minutes is essential, but the specific focus should be on monitoring for signs of circulatory overload.

5. A newly licensed nurse tells a charge nurse that he is unsure about accepting telephone medication prescriptions. Which of the following providers should the charge nurse identify as having the legal ability to give telephone medication prescriptions?

• A. Anesthesiologists
• B. Physician assistants
• C. Hospital pharmacists
• D. Nurse practitioners

Correct answer: A

Rationale: The correct answer is A: Anesthesiologists. Anesthesiologists are licensed providers who have the legal authority to give telephone medication prescriptions. Physician assistants (choice B), hospital pharmacists (choice C), and nurse practitioners (choice D) do not typically have the legal ability to provide medication prescriptions over the phone. In this scenario, the charge nurse should inform the newly licensed nurse that anesthesiologists are one of the providers who can legally give telephone medication prescriptions.

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