Nursing Elites

1. You are working the 4 pm to 12 midnight evening shift. You are taking care of a group of patients. The supervising RN identifies 5 patients who get a medication at 'HS'. When will you give this medication?

• A. After the dinner meal
• B. Whenever requested
• C. At the patient's bedtime
• D. Before the end of the shift

Correct answer: C

Rationale: The correct answer is to give the medication at the patient's bedtime. 'HS' is a medical abbreviation that stands for 'hora somni,' which translates to 'at bedtime' or 'at the hours of sleep.' This timing ensures that the medication is administered appropriately to align with the patient's sleep schedule and maximize its effectiveness. Choices A, B, and D are incorrect because giving the medication after dinner, whenever requested, or before the end of the shift may not coincide with the intended purpose of the medication, potentially affecting its efficacy and patient outcomes.

2. During the implementation phase of the nursing process when working with a hospitalized adult, which of the following actions would the nurse take?

• A. Formulate a nursing diagnosis of impaired gas exchange
• B. Record in the medical record the distance a client ambulates in the hall
• C. Write individualized nursing orders in the care plan
• D. Compare client responses to the desired outcomes for pain relief

Correct answer: B

Rationale: During the implementation phase of the nursing process, the nurse is responsible for carrying out or delegating nursing interventions and documenting nursing activities and client responses in the medical records. Option A involves diagnosing, which is part of the nursing process's earlier phases. Option C pertains to planning, which precedes implementation. Option D relates to evaluation, which comes after the implementation phase.

3. On admission to the psychiatric unit, the client is trembling and appears fearful. The nurse's initial response should be to:

• A. Give the client orientation materials and review the unit rules and regulations.
• B. Introduce him/her and accompany the client to the client's room.
• C. Take the client to the day room and introduce him/her to the other clients.
• D. Ask the nursing assistant to get the client's vital signs and complete the admission search.

Correct answer: B

Rationale: Anxiety is triggered by change that threatens the individual's sense of security. In response to anxiety in clients, the nurse should remain calm, minimize stimuli, and move the client to a calmer, more secure/safe setting. The correct initial response is to introduce the client and accompany them to their room. This approach helps the client feel oriented, safe, and supported. Giving orientation materials or reviewing rules and regulations may overwhelm the client further. Taking the client to the day room and introducing them to other clients could increase anxiety by exposing them to unfamiliar faces. Asking the nursing assistant to get vital signs and complete admission tasks can wait until the client feels more settled and secure in their environment.

4. A patient with Parkinson's disease is experiencing difficulty swallowing. What potential problem associated with dysphagia has the greatest influence on the plan of care?

• A. Anorexia
• B. Aspiration
• C. Self-care deficit
• D. Inadequate intake

Correct answer: B

Rationale: When a person experiences dysphagia (difficulty swallowing), the greatest concern is aspiration. Aspiration occurs when food or fluids enter the trachea and lungs instead of going down the esophagus. This can lead to serious complications such as choking, airway obstruction, and aspiration pneumonia. Anorexia (Choice A) refers to a loss of appetite, which is not the primary concern with dysphagia. Self-care deficit (Choice C) and inadequate intake (Choice D) are important considerations but do not have as direct an impact on the immediate safety and health risks associated with aspiration in dysphagia.

5. The nurse is discussing the term subculture with a student nurse. Which statement by the nurse would best describe subculture?

• A. "Fitting as many people as possible into the majority culture."?
• B. "Identifying small groups of people who do not want to be identified with the larger culture."?
• C. "Singling out groups of people who suffer differential and unequal treatment as a result of cultural variations."?
• D. "Recognizing groups of people within a culture with shared characteristics that are not common to all members of the culture."?

Correct answer: D

Rationale: A subculture refers to a group of people within a larger culture who share distinct beliefs, values, or attitudes that are not universal among all members of the larger culture. Subcultures can emerge based on factors such as ethnicity, religion, education, occupation, age, and gender. The correct answer describes the concept of a subculture accurately. Choices A, B, and C are incorrect because they do not capture the essence of a subculture. Fitting people into the majority culture, identifying small groups who distance themselves from the larger culture, or singling out individuals facing differential treatment do not define subculture. Subcultures represent specific groups with shared characteristics that differentiate them from the broader cultural norms.

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