Nursing Elites

1. While supervising the care of several clients, which action requires intervention by the charge nurse?

• A. A nurse photocopies a client's diagnostic test results.
• B. An assistive personnel documents the client's vital signs on the client's paper-based graphic record.
• C. The unit secretary faxes a client's laboratory results to the provider.
• D. An RN stays with a client to discuss her understanding of her vital signs that were requested.

Correct answer: A

Rationale: The charge nurse should intervene when a nurse photocopies a client's diagnostic test results as it violates patient confidentiality and privacy. This action breaches HIPAA regulations, and sensitive patient information should not be photocopied without proper authorization. The other actions are within the scope of practice and do not raise concerns regarding patient privacy or confidentiality.

2. When caring for a patient who just received a terminal diagnosis and is tearful and frightened, what is the best action to demonstrate caring?

• A. Call the patient's spiritual leader to talk to the patient.
• B. Call the patient's family and ask them to come sit with the patient.
• C. Cry with the patient while sympathizing with their situation.
• D. Sit with the patient and listen to their fears.

Correct answer: D

Rationale: In situations where a patient receives a terminal diagnosis and is emotionally distressed, it is essential to provide empathy and support. Sitting with the patient and actively listening to their fears allows the patient to express their emotions and concerns. This action demonstrates genuine care and compassion, showing the patient that their feelings are acknowledged and valued. It creates a therapeutic environment that fosters trust and emotional well-being, helping the patient cope with the distressing news. Calling the patient's spiritual leader (Choice A) may not address the immediate emotional needs of the patient. Calling the patient's family (Choice B) can be comforting but might not directly address the patient's fears. Crying with the patient (Choice C) can blur professional boundaries and may not be as beneficial as actively listening and providing support.

3. What is essential for student nurses to perform at their physical and emotional best?

• A. Engaging in adequate exercise.
• B. Eating plenty of carbohydrates the day before.
• C. Drinking caffeinated beverages before clinical.
• D. Studying late into the night to be prepared.

Correct answer: A

Rationale: To perform at their physical and emotional best, it is essential for student nurses to engage in adequate exercise. Regular physical activity not only helps maintain physical health but also contributes to emotional well-being, which is crucial for optimal clinical performance. Exercise can help reduce stress, improve mood, increase energy levels, and enhance overall cognitive function, all of which are essential for students to perform effectively in clinical settings. Choices B, C, and D are incorrect. Eating plenty of carbohydrates the day before, drinking caffeinated beverages before clinical, and studying late into the night may not necessarily lead to optimal physical and emotional performance. While nutrition is important, a balanced diet is more effective than simply focusing on carbohydrates. Caffeinated beverages can lead to dehydration and interfere with sleep patterns, and studying late into the night can impair cognitive function and increase stress levels, which are counterproductive to performing at one's best.

4. What motivates a nurse to perform tasks, whether at work or off duty?

• A. Personal motivation
• B. Facility policies
• C. Fear of reprisals
• D. Parental expectations

Correct answer: A

Rationale: Personal motivation is the driving force behind a nurse's actions, influencing their decisions and behaviors both during work hours and while off duty. It is an internal drive that compels them to act in a certain way, regardless of external factors such as facility policies, fear of reprisals, or parental expectations. While facility policies may guide their actions within the workplace, they do not address motivation. Fear of reprisals and parental expectations are external factors and are less likely to be the primary motivators for a nurse's actions.

5. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

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