Nursing Elites

1. The nurse on the postsurgical unit received a client who was transferred from the post-anesthesia care unit (PACU) and is planning care for this client. The nurse understands that staff should begin planning for this client’s discharge at which point during the hospitalization?

• A. Is admitted to the surgical unit
• B. Is transferred from the PACU to the postsurgical unit
• C. Is able to perform activities of daily living independently
• D. Has been assessed by the healthcare provider for the first time after surgery

Correct answer: A

Rationale: Discharge planning should begin as soon as the patient is admitted to the surgical unit to ensure a smooth transition. It is important to start early to address any potential barriers to discharge, coordinate resources, and provide adequate education and support. Choices B, C, and D are not the appropriate points to start discharge planning as they do not mark the beginning of the hospitalization phase related to the surgical unit.

2. The client with peripheral vascular disease is being taught by the nurse. Which interventions should the nurse discuss with the client?

• A. Keep the area between the toes dry.
• B. Wear comfortable, well-fitting shoes.
• C. Cut toenails straight across.
• D. A, B

Correct answer: D

Rationale: The correct interventions for a client with peripheral vascular disease include keeping the area between the toes dry and wearing comfortable, well-fitting shoes. Choice A is correct as moisture between the toes can lead to skin breakdown and infection. Choice B is also correct as proper footwear helps prevent injury and promotes circulation. Choice C, cutting toenails straight across, is incorrect for peripheral vascular disease clients as cutting them in an arch can reduce the risk of ingrown toenails, which is important for clients with diabetes to prevent complications. Therefore, choices A and B are the most appropriate interventions for the client with peripheral vascular disease.

3. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?

• A. Discuss the importance of tapering medications when discontinuing medication
• B. Explain that the dose will need to be decreased during times of stress or infection
• C. Instruct the client to take medication on an empty stomach with a glass of water
• D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet

Correct answer: A

Rationale: The correct answer is to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.

4. The medical C4I headquarters has automated data processing systems that aid in which of the following?

• A. Patient accountability
• B. Tracking the movement of patients
• C. Management of health service logistics systems
• D. Patient accountability, tracking the movement of patients, and management of health service logistics systems

Correct answer: D

Rationale: The correct answer is D because the automated data processing systems in the medical C4I headquarters play a role in patient accountability, tracking the movement of patients, and managing health service logistics systems. These systems help in efficiently managing patient information, monitoring and coordinating patient movements, and optimizing the logistics involved in health services. Choices A, B, and C are incorrect because they represent individual aspects that are all encompassed by the functions of the automated data processing systems in the C4I headquarters.

5. What type of food should a patient taking anticoagulants be cautious about consuming?

• A. High-protein foods
• B. High-fiber foods
• C. High-vitamin K foods
• D. High-calcium foods

Correct answer: C

Rationale: Patients taking anticoagulants should be cautious about consuming high-vitamin K foods. Vitamin K can interfere with the effectiveness of anticoagulants by affecting blood clotting. Choices A, B, and D are incorrect because they do not directly interact with the action of anticoagulants.

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