Nursing Elites

1. 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.

2. Which of the following are important techniques when giving directions to subordinates? (EXCEPT)

• A. Know the context of the instructions.
• B. Use lateral communication.
• C. Verify feedback.
• D. Get positive attention.

Correct answer: B

Rationale: The correct answer is B: 'Use lateral communication.' When giving directions to subordinates, it is important to know the context of the instructions, get positive attention, verify feedback, and give follow-up communication. Lateral communication refers to communication between individuals or groups on the same organizational level, which is not directly related to giving directions to subordinates. Choices A, C, and D are important techniques that help ensure effective communication with subordinates.

3. The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions would be which of the following strategies?

• A. Verifying through feedback
• B. Follow-up communication
• C. Getting positive attention
• D. Knowing the context of the instruction

Correct answer: A

Rationale: Asking the subordinate to repeat the instructions is a strategy known as verifying through feedback. This approach ensures that the receiver has understood the request correctly. Choice B, 'Follow-up communication,' refers to checking in after the initial communication, not necessarily asking for repetition. Choice C, 'Getting positive attention,' is unrelated to confirming understanding. Choice D, 'Knowing the context of the instruction,' deals with understanding the background or reasons behind the instructions, not confirming comprehension.

4. When a policy violation occurs, what are the necessary steps for the nurse manager? (EXCEPT)

• A. Describing the staff nurse's behavior that violated the policy
• B. Terminating the staff immediately
• C. Confrontation
• D. Determining the employee's awareness of the policy

Correct answer: B

Rationale: When a policy violation occurs, the necessary steps for the nurse manager include: describing the staff nurse's behavior that violated the policy, confrontation as a communication technique to address specific issues, and determining the employee's awareness of the policy. Terminating the employee immediately is not always the appropriate response to a policy violation, as there may be other corrective actions or interventions that can be taken to address the issue without resorting to termination. It is crucial to follow due process, provide guidance, and support to help employees understand and rectify their behavior.

5. Which information is most important for the nurse to report to the health care provider before a patient with type 2 diabetes is prepared for a coronary angiogram?

• A. The patient�s most recent HbA1C was 6.5%
• B. The patient�s admission blood glucose is 128 mg/dL.
• C. The patient took the prescribed metformin (Glucophage) today
• D. The patient took the prescribed captopril (Capoten) this morning.

Correct answer: C

Rationale:

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