Nursing Elites

1. A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first?

• A. Remove the restraints from the client's wrists
• B. Review the chart for nonrestraint alternatives for agitation
• C. Speak with the AP about the incident
• D. Inform the unit manager of the incident

Correct answer: A

Rationale: The correct action for the nurse to take first is to remove the restraints from the client's wrists. Restraints should not be applied without a prescription due to the risk of harm to the client. Removing the restraints promptly is a priority to ensure the client's safety. Reviewing nonrestraint alternatives, speaking with the AP, and informing the unit manager can follow after ensuring the client's immediate safety by removing the restraints.

2. Which of the following healthcare providers can legally have access to all, or part, of a patient's medical record because they have a 'need to know'? Select one that does not apply.

• A. Student nurses caring for a particular patient
• B. Registered nurses when they are not caring for a particular patient
• C. The Vice President for nursing who is investigating a patient fall
• D. Licensed practical nurses caring for a particular patient

Correct answer: B

Rationale: Student nurses, licensed practical nurses, the Vice President for nursing investigating a fall, and quality assurance nurses have a 'need to know' basis to access patient records. Registered nurses who are not directly involved in the care of a patient do not have a legitimate reason or 'need to know' to access that patient's medical records, making choice B the correct answer. The Vice President for nursing investigating a specific incident and licensed practical nurses directly involved in a patient's care have legitimate reasons to access the medical records, ensuring continuity and quality of care.

3. Which of the following strategies can help reduce healthcare-associated infections?

• A. Using outdated medical equipment
• B. Implementing strict hygiene protocols
• C. Increasing patient wait times
• D. Reducing nursing staff

Correct answer: B

Rationale: Correct Answer: Implementing strict hygiene protocols can help reduce healthcare-associated infections. By maintaining high standards of hygiene, such as proper handwashing, sterilization of equipment, and cleanliness of the environment, the spread of infections can be minimized. Choices A, C, and D are incorrect. Using outdated medical equipment can increase the risk of infections due to lack of proper maintenance and sterilization. Increasing patient wait times may lead to frustration but does not directly impact infection rates. Reducing nursing staff can compromise patient care and monitoring but is not specifically related to reducing healthcare-associated infections.

4. The doctor has ordered 500 mg of a medication PO once a day. The tablets on hand are labeled as 1 tablet = 250 mg. How many tablets will you administer to your patient?

• A. 1 Tablet
• B. 2 Tablets
• C. 3 Tablets
• D. 4 Tablets

Correct answer: B

Rationale: To calculate the number of tablets needed, divide the total dosage prescribed (500 mg) by the dosage per tablet (250 mg per tablet). 500 mg / 250 mg per tablet = 2 tablets. Therefore, the correct answer is 2 tablets. Choices A, C, and D are incorrect as they do not accurately reflect the correct calculation based on the provided information.

5. A client with DM states, 'I cannot eat big meals; I prefer to snack throughout the day.' The nurse should carefully explain that the:

• A. Regulated food intake is crucial for control
• B. Restricting salt and sugar is the main concern
• C. Opting for small, frequent meals aids digestion
• D. Consuming large meals can contribute to weight issues

Correct answer: A

Rationale: In clients with diabetes, regulated food intake is crucial for controlling blood glucose levels. Choice A is the correct answer because maintaining consistent meal sizes and timings helps in managing blood sugar levels effectively. Choice B is incorrect because while monitoring salt and sugar intake is important, it is not the primary consideration in this scenario. Choice C is incorrect as the focus is on regulating food intake rather than aiding digestion. Choice D is also incorrect because consuming large meals can indeed lead to fluctuations in blood glucose levels, but the primary concern in this case is the regulation of food intake for better control of diabetes.

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