Nursing Elites

1. A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of H1N1 who have been seen during the last month in a community health clinic. Which action should the charge nurse take?

• A. Ask if permission has been obtained from the research committee.
• B. Ask the student to sign a standard waiver form.
• C. Obtain written authorization from clients to release the information.
• D. Provide the information for research purposes only.

Correct answer: C

Rationale: The correct action for the charge nurse to take is to obtain written authorization from clients to release the information. This step is crucial to ensure compliance with privacy laws and ethical standards. Asking for permission from the research committee (Choice A) may not address the individual clients' rights to privacy. Asking the student to sign a standard waiver form (Choice B) is not appropriate, as the authorization should come from the clients themselves. Providing the information for research purposes only (Choice D) without proper authorization violates client confidentiality and privacy.

2. Following an emergency Cesarean delivery, the nurse encourages the new mother to breastfeed her newborn. The client asks why she should breastfeed now. Which information should the nurse provide?

• A. To bond with the baby.
• B. To help the baby latch on better.
• C. To stimulate contraction of the uterus.
• D. To promote milk production.

Correct answer: C

Rationale: The correct answer is C: 'To stimulate contraction of the uterus.' After delivery, breastfeeding helps in stimulating the release of oxytocin, which triggers the contraction of the uterus. This contraction is crucial to prevent uterine hemorrhage and facilitate the involution process. Choices A, B, and D are incorrect. While breastfeeding can indeed help in bonding with the baby and promoting milk production, in the immediate postpartum period after a Cesarean section, the priority is to ensure uterine contraction to prevent complications.

3. The healthcare provider is assessing a client who has a nasogastric tube to low intermittent suction. Which finding indicates that the client may have developed hypokalemia?

• A. Muscle weakness and cramps.
• B. Nausea and vomiting.
• C. Constipation.
• D. Increased blood pressure.

Correct answer: A

Rationale: Muscle weakness and cramps are characteristic signs of hypokalemia, a condition marked by low levels of potassium in the blood. Potassium is essential for proper muscle function, and its deficiency can lead to muscle weakness and cramps. In the context of a client with a nasogastric tube to low intermittent suction, the loss of potassium through suctioning can contribute to the development of hypokalemia. Nausea and vomiting (choice B) are more commonly associated with gastrointestinal issues rather than hypokalemia. Constipation (choice C) is not a typical finding of hypokalemia; instead, it can be a sign of other gastrointestinal problems. Increased blood pressure (choice D) is not a direct manifestation of hypokalemia; in fact, low potassium levels are more commonly associated with decreased blood pressure.

4. The healthcare professional is developing a safety program for older adults at a senior center. Which topic should the professional prioritize?

• A. medication management
• B. fall prevention
• C. fire safety
• D. emergency preparedness

Correct answer: B

Rationale: Fall prevention should be prioritized for older adults as falls are a significant cause of injury and hospitalization in this population. Addressing fall prevention measures can help reduce the risk of falls and improve the overall safety and well-being of older adults. Medication management, fire safety, and emergency preparedness are also important topics, but fall prevention takes precedence due to its direct impact on the health and safety of older adults.

5. The healthcare provider is caring for a client with a chest tube following thoracic surgery. Which intervention should the healthcare provider include in the plan of care?

• A. Clamp the chest tube for 30 minutes every 2 hours.
• B. Milk the chest tube to ensure patency.
• C. Keep the drainage system at the level of the chest.
• D. Ensure that the chest tube is not clamped or kinked.

Correct answer: D

Rationale: Ensuring that the chest tube is not clamped or kinked is essential to maintain proper drainage and prevent complications. Clamping the chest tube can lead to a buildup of pressure in the pleural space, causing potential harm to the client. Milking the chest tube is not recommended as it can cause damage to the delicate tubing. Keeping the drainage system at the level of the chest ensures proper drainage by gravity, preventing backflow of fluids, but ensuring the tube is not clamped or kinked takes precedence in this scenario.

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