Nursing Elites

1. A healthcare professional is assessing a patient's fluid balance. What is the most reliable indicator of fluid status?

• A. Monitor the patient's vital signs.
• B. Check the patient's weight daily.
• C. Measure the patient's intake and output.
• D. Monitor the patient's urine color.

Correct answer: B

Rationale: Checking the patient's weight daily is the most reliable indicator of fluid status because weight changes can directly reflect fluid retention or loss. Monitoring vital signs (Choice A) can provide some information but is not as specific as weight changes. Measuring intake and output (Choice C) is crucial but may not always accurately reflect fluid balance. Monitoring urine color (Choice D) can give some insights into hydration levels, but it is not as reliable as daily weight checks for assessing overall fluid status.

2. What is the most appropriate action for a healthcare professional to take when a medication error occurs?

• A. Document the error in the patient's medical record.
• B. Report the error to the healthcare provider immediately.
• C. Apologize to the patient and explain what happened.
• D. Continue administering the medication and monitor the patient closely.

Correct answer: B

Rationale: When a medication error occurs, the most appropriate action for a healthcare professional is to report the error to the healthcare provider immediately. This is crucial for ensuring prompt corrective action to mitigate any potential harm to the patient. Documenting the error is important but should come after reporting it to the relevant authorities. Apologizing to the patient is important for maintaining trust and communication but should not take precedence over reporting and addressing the error. Continuing to administer the medication without addressing the error is unsafe and goes against patient safety protocols.

3. What is a key component of a comprehensive discharge plan for a patient with heart failure?

• A. Advising on appropriate physical activity and exercise
• B. Fluid restriction to prevent fluid overload
• C. Dietary recommendations, including a low-sodium diet
• D. Medication management, including diuretics and ACE inhibitors

Correct answer: A

Rationale: The main components of a comprehensive discharge plan for a patient with heart failure include advising on appropriate physical activity and exercise to improve cardiovascular health and overall well-being. While fluid restriction and dietary recommendations are important aspects of heart failure management, advising on physical activity and exercise is crucial for improving cardiac function and quality of life post-discharge. Medication management is also essential but focusing on physical activity is particularly relevant for long-term management and preventing readmissions.

4. What are the key components of a pain assessment in a postoperative patient?

• A. Checking the effectiveness of pain interventions
• B. Observing for nonverbal signs of pain like grimacing
• C. Assessing the location, duration, and quality of the pain
• D. Asking the patient to rate their pain on a scale of 1-10

Correct answer: A

Rationale: The correct answer is A because in a postoperative patient, it is crucial to evaluate the effectiveness of the pain interventions that have been implemented. While choices B, C, and D are important aspects of a pain assessment, they do not specifically address the key component of assessing the effectiveness of the interventions applied postoperatively.

5. A healthcare professional is assessing a client 15 minutes after administering morphine sulfate 2 mg via IV push. The healthcare professional should identify which of the following findings as an adverse effect of the medication?

• A. Drowsy but responsive when her name is called
• B. SaO2 94%
• C. Respiratory rate 8/min
• D. Pain level of 6 on a scale from 0 to 10

Correct answer: C

Rationale: A respiratory rate of 8/min is a significant adverse effect of morphine that indicates respiratory depression, which requires immediate intervention to prevent further complications. The client may not be effectively ventilating, leading to hypoxia and respiratory acidosis. Option A is less concerning as being drowsy but responsive is a common side effect of morphine. Option B indicates decreased oxygen saturation, which is also a concern but not as severe as respiratory depression. Option D is important but not as critical as the potential respiratory compromise indicated by the low respiratory rate.

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