Nursing Elites

1. A client who is nonambulatory notifies the nurse that their trash can is on fire. After the nurse confirms the presence of the fire, which of the following actions should the nurse take next?

• A. Activate the emergency fire alarm.
• B. Extinguish the fire.
• C. Evacuate the client.
• D. Confine the fire.

Correct answer: D

Rationale: In this situation, the nurse's priority should be to confine the fire. By confining the fire, the nurse can prevent it from spreading further and causing more harm. Activating the emergency fire alarm (choice A) is important but should come after confining the fire. Extinguishing the fire (choice B) might not be safe for the nurse to do without proper equipment and training. Evacuating the client (choice C) can be considered once the fire is confined to ensure the client's safety.

2. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision-makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the ethical decision-making process, after identifying the decision-makers involved, the next step is typically planning. During the planning stage, the RN will consider the available options, weigh the ethical principles involved, and develop a course of action to address the ethical dilemma. Choice A, Assessment, involves gathering information and data about the situation. Choice B, Diagnosis, involves analyzing the gathered information to identify the ethical issue. Choice D, Implementation, comes after planning and involves putting the chosen course of action into practice.

3. During a performance appraisal, how should the manager best provide constructive feedback to an employee?

• A. Focus only on the negative aspects of performance
• B. Provide general comments without specifics
• C. Discuss specific examples of strengths and areas for improvement
• D. Delay feedback until the next appraisal period

Correct answer: C

Rationale: During a performance appraisal, the best approach to provide constructive feedback is by discussing specific examples of strengths and areas for improvement. This method allows the employee to understand what they are excelling at and where they need to focus on development. By highlighting both aspects, the employee can work on enhancing their performance effectively. Option A is incorrect because solely focusing on the negative aspects can demotivate the employee and hinder their growth. Option B is incorrect as providing general comments without specifics does not offer clear guidance for improvement. Option D is also incorrect as delaying feedback can prevent timely corrective actions and hinder performance progress.

4. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

5. During a home safety assessment, a nurse is evaluating a client who is receiving supplemental oxygen. Which observation should the nurse identify as a proper safety protocol?

• A. The client has a weekly inspection checklist for oxygen equipment.
• B. The client stores an extra oxygen tank on its side under their bed.
• C. The client identifies the location of a fire extinguisher.
• D. The client uses a wool blanket on their bed.

Correct answer: A

Rationale: The correct answer is A because having a weekly inspection checklist for oxygen equipment ensures that the client can monitor the safety and functionality of the oxygen equipment regularly. This is crucial for maintaining a safe environment. Choice B is incorrect because storing an extra oxygen tank on its side under the bed can pose a safety hazard, as tanks should be stored upright. Choice C is a good safety practice, but it is not directly related to oxygen use. Choice D is incorrect because wool blankets are flammable and should not be used by clients receiving supplemental oxygen due to the increased risk of fire.

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