Nursing Elites

1. A nurse caring for a client under airborne precautions notes that the client is scheduled for a nuclear scan. What is the appropriate action for the nurse to take?

• A. Planning to have the nuclear scan performed at the bedside
• B. Calling the nuclear medicine department and telling the technician that the test will have to be delayed until airborne precautions have been discontinued
• C. Asking the technicians in the nuclear scan department to wear masks
• D. Placing a surgical mask on the client for transport and for contact with other individuals

Correct answer: D

Rationale: The correct action for the nurse is to place a surgical mask on the client for transport and for contact with other individuals when a patient under airborne precautions requires movement. This helps prevent the spread of infectious agents. Planning to have the nuclear scan at the bedside (Choice A) may not be feasible or appropriate. Calling the nuclear medicine department to delay the test (Choice B) may inconvenience the client and disrupt the scheduled procedure. Asking technicians in the nuclear scan department to wear masks (Choice C) does not provide adequate protection for others who may come into contact with the client outside the department.

2. A client with a history of falls is being admitted to the unit. What intervention should the nurse implement first?

• A. Increase the client's medication to ensure they don't fall.
• B. Use bed alarms to monitor the client's movements.
• C. Encourage the client to use a walker for mobility.
• D. Assign the client to a nursing assistant for supervision.

Correct answer: B

Rationale: The correct answer is B: 'Use bed alarms to monitor the client's movements.' When a client with a history of falls is admitted, the nurse's initial intervention should focus on fall prevention measures. Using bed alarms to monitor the client's movements can help alert the healthcare team if the client attempts to get out of bed and reduce the risk of falls. Choice A is incorrect because increasing medication should not be the first intervention as it may not address the underlying causes of falls and can have adverse effects. Choice C may be appropriate but is not the priority over implementing safety measures like bed alarms. Choice D is incorrect as assigning the client to a nursing assistant for supervision alone may not be as effective as utilizing bed alarms for continuous monitoring.

3. A healthcare provider is reviewing a client's lab results. Which of the following lab values should the provider report?

• A. Magnesium 1.9 mEq/L
• B. Potassium 3.6 mEq/L
• C. Sodium 126 mEq/L
• D. Chloride 99 mEq/L

Correct answer: C

Rationale: The correct answer is C: Sodium 126 mEq/L. A sodium level of 126 mEq/L is below the normal range, indicating hyponatremia, which can have serious health implications and should be reported to the healthcare provider for further evaluation and intervention. Choices A, B, and D are within or close to the normal ranges for magnesium, potassium, and chloride, respectively, and do not require immediate reporting as they are not significantly abnormal.

4. A nurse is caring for a client with a new colostomy. What is the nurse's responsibility regarding stoma care?

• A. Educate the client on how to care for the stoma independently.
• B. Contact the stoma nurse to assist the client with care.
• C. Delegate the care of the stoma to a nursing assistant.
• D. Wait until the next shift to address the stoma care.

Correct answer: B

Rationale: The correct answer is to contact the stoma nurse to assist the client with care. Stoma nurses are specially trained to provide guidance on stoma care, especially for clients with new ostomies. Instructing the client to care for the stoma independently (Choice A) may not be appropriate initially as they may need professional guidance. Delegating the care of the stoma to a nursing assistant (Choice C) is not recommended as specialized care is required. Waiting until the next shift (Choice D) is not ideal as stoma care should not be delayed.

5. A patient with chronic obstructive pulmonary disease (COPD) is being cared for by a nurse. What is the most appropriate action to improve the patient's oxygenation?

• A. Encourage the patient to use incentive spirometry.
• B. Administer oxygen via nasal cannula as prescribed.
• C. Assist the patient with coughing and deep breathing exercises.
• D. Position the patient in a high Fowler's position.

Correct answer: B

Rationale: Administering oxygen via nasal cannula as prescribed is the most appropriate action to improve the patient's oxygenation in COPD. Oxygen therapy helps maintain adequate oxygen levels in the blood, which is crucial for managing COPD. Encouraging the use of incentive spirometry, assisting with coughing and deep breathing exercises, and positioning the patient in high Fowler's position are all beneficial interventions, but administering oxygen is the priority for immediate oxygenation support in COPD.

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