Nursing Elites

1. What is involved in client education by the nurse?

• A. Telling the client everything about their disease, what will happen in the course of the disease, and the outcome.
• B. Giving information to the client that is accurate and understandable.
• C. Informing the client that the pain they experience might not be real.
• D. Administering medication to the client when they experience pain.

Correct answer: B

Rationale: Client education by the nurse involves providing accurate and understandable information to the client. It is essential to offer relevant details without overwhelming them, making choice B the correct answer. Choice A is incorrect because providing excessive details can confuse the client rather than empower them with necessary knowledge. Choice C is incorrect as it is not the role of the nurse to question the reality of a client's pain; instead, they should address and manage the pain effectively. Choice D is incorrect as client education focuses on providing information and empowering clients with knowledge, not just administering medication.

2. Which of the following statements indicates that the provider understands how to promote rest and sleep for the client?

• A. If you would prefer not to be disturbed, we can postpone all vital signs and assessments until tomorrow morning.
• B. With your physical therapy appointments, you cannot nap more during the day even if your sleep is often interrupted at nighttime.
• C. I can try to incorporate any sleep rituals or an ideal bedtime into your routine.
• D. We cannot group together medications, assessments, and other interventions so you may have multiple interruptions at night.

Correct answer: C

Rationale: The correct answer is, 'I can try to incorporate any sleep rituals or an ideal bedtime into your routine.' To promote rest and sleep, the provider should consider incorporating the client's preferred sleep rituals or bedtime routine. This statement shows an understanding of the importance of individualizing care to promote restful sleep. Choices A, B, and D do not directly address promoting rest and sleep. Choice A focuses on postponing assessments, Choice B addresses napping during the day, and Choice D mentions multiple interruptions at night, none of which directly support promoting rest and sleep for the client.

3. When managing time effectively, which of the following stimuli should the nurse respond to first?

• A. the physician's loud verbal direction
• B. the nursing supervisor who is going to a meeting
• C. unit staff leaving on a break
• D. the care needs of the returning postoperative client just exiting the elevator

Correct answer: D

Rationale: The correct answer is to attend to the care needs of the returning postoperative client just exiting the elevator first. In a healthcare setting, patient care should always take precedence, especially for complex or unstable clients requiring immediate assessment and care. The physician's loud verbal direction, the nursing supervisor going to a meeting, and unit staff leaving on a break are important but do not involve direct patient care. Therefore, the nurse should prioritize responding to the returning postoperative client to ensure their immediate needs are met.

4. Which of these should not be included when calculating a client's fluid intake?

• A. ice chips
• B. Jell-O�
• C. pudding
• D. IV fluid from an antibiotic piggyback

Correct answer: C

Rationale: Pudding is a semi-solid and does not contribute significantly to fluid intake as it does not melt at room temperature. Therefore, it should not be included in fluid intake calculations. On the other hand, ice chips, Jell-O�, and IV fluid from an antibiotic piggyback are all sources of fluid that can significantly contribute to a client's total fluid intake and should be considered when calculating it. Ice chips and Jell-O� provide hydration upon melting, while IV fluid directly adds to the fluid volume in the body.

5. When observing a dressing change by a graduate nurse on a Stage III pressure ulcer to the greater trochanter by the staff nurse, a need for further teaching is indicated after the following observation by the nurse:

• A. The new graduate nurse irrigates the pressure ulcer with 50cc of NS.
• B. The new graduate irrigates the pressure ulcer with half-strength hydrogen peroxide.
• C. The new graduate packs the wound with sterile kerlix soaked in NS.
• D. The new graduate applies a Duoderm dressing over the wound after cleansing.

Correct answer: B

Rationale: The correct answer is that the new graduate irrigates the pressure ulcer with half-strength hydrogen peroxide. Pressure ulcers should not be cleaned with substances that are cytotoxic, such as hydrogen peroxide or betadine. This can cause further damage to the wound and delay the healing process. Choice A is incorrect because irrigating the pressure ulcer with normal saline is an appropriate practice. Choice C is incorrect because packing the wound with sterile kerlix soaked in normal saline is also an appropriate step. Choice D is incorrect because applying a Duoderm dressing after cleansing is a standard procedure in wound care.

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