Nursing Elites

1. A case manager is preparing a discharge plan for a client following coronary artery bypass grafting surgery. Which of the following client issues should the nurse address first?

• A. Inadequate food supply
• B. Low pain tolerance
• C. Limited social support
• D. Decreased self-esteem

Correct answer: A

Rationale: The nurse should address the inadequate food supply first as it directly impacts the client's health post-discharge. Proper nutrition is crucial for recovery after surgery, especially such as coronary artery bypass grafting. While low pain tolerance, limited social support, and decreased self-esteem are all important issues to address, addressing the client's nutritional needs is the priority in this scenario to ensure optimal recovery and healing.

2. A nurse in a clinic is reviewing laboratory reports for a group of clients. Which of the following diseases should the nurse report to the state health department?

• A. Pertussis
• B. Group B streptococcal disease
• C. Respiratory syncytial virus
• D. Rotavirus

Correct answer: A

Rationale: Pertussis is the correct answer because it is a reportable disease that healthcare providers are required by law to report to public health authorities. This infectious disease poses a significant public health risk and needs to be monitored closely to prevent outbreaks and implement control measures. Group B streptococcal disease, Respiratory syncytial virus, and Rotavirus are important conditions but are not typically reportable to the state health department. These diseases may require specific precautions in healthcare settings, but they do not fall under mandatory reporting requirements.

3. A nurse is supervising an assistive personnel (AP) who is feeding a client who has dysphagia. Which of the following actions by the AP should the nurse identify as correct technique?

• A. Elevating the head of the client's bed to 30 degrees during mealtime
• B. Withholding fluids until the end of the meal
• C. Providing a 10-minute rest period prior to meals
• D. Instructing the client to place her chin toward her chest when swallowing

Correct answer: D

Rationale: The correct technique for a client with dysphagia is to instruct them to place their chin toward their chest when swallowing. This action helps to close off the airway during swallowing, reducing the risk of aspiration. Elevating the head of the client's bed to 30 degrees during mealtime helps prevent aspiration, but this is not the responsibility of the AP. Withholding fluids until the end of the meal can lead to dehydration and is not a recommended practice. Providing a 10-minute rest period prior to meals is not specifically related to improving swallowing safety for clients with dysphagia.

4. To resolve a conflict between staff members regarding potential changes in policy, a nurse manager decides to implement the changes she prefers regardless of the feelings of those who oppose those changes. Which of the following conflict-resolution strategies is the nurse manager using?

• A. Competing
• B. Collaborating
• C. Compromising
• D. Cooperating

Correct answer: A

Rationale: The nurse manager is utilizing the competing conflict-resolution strategy. Competing involves making decisions based on one's preferences without considering the opinions or feelings of others. In this scenario, the nurse manager is unilaterally implementing changes despite opposition, demonstrating a competitive approach. Collaborating involves working together to find a mutually beneficial solution, compromising involves finding a middle ground acceptable to both parties, and cooperating involves working together towards a shared goal. These options are not applicable in this situation as the nurse manager is imposing her preferred changes without regard for others' input.

5. A nurse is providing an in-service about client rights for a group of nurses. Which of the following statements should the nurse include in the service?

• A. A nurse can disclose information to a family member with the client's permission
• B. A nurse can apply restraints on an as-needed basis
• C. A nurse can administer medications without consent to a client as part of a research study
• D. A nurse is responsible for informing clients about treatment options

Correct answer: A

Rationale: The correct statement to include in the in-service about client rights is that a nurse can disclose information to a family member with the client's permission. This respects the client's autonomy and privacy. Choice B is incorrect because restraints should only be applied based on a specific assessment and order, not on an as-needed basis. Choice C is incorrect as administering medications without consent is a violation of ethical principles and legal standards. Choice D is incorrect because while nurses should educate clients about treatment options, the ultimate decision lies with the client after being informed.

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