Nursing Elites

1. A nurse is caring for a client who is requesting to leave the facility against medical advice (AMA). The client states, 'I am ready to go immediately.' Which of the following actions should the nurse take first?

• A. Teach the client about the potential health risks of leaving early
• B. Ask the client to sign a document stating they are leaving AMA
• C. Document the client's statement in direct quotes in the medical record
• D. Complete an incident report detailing the client scenario

Correct answer: A

Rationale: The correct action for the nurse to take first is to educate the client about the potential health risks of leaving against medical advice (AMA). By providing this information, the nurse can help the client make an informed decision regarding their healthcare. Choice B, asking the client to sign a document, can be done after the client has been informed about the risks. Choice C, documenting the client's statement, is important but should not take precedence over educating the client. Choice D, completing an incident report, is not the priority when a client is requesting to leave AMA.

2. A client with neuropathic pain has a new prescription for amitriptyline once per day. What should the nurse include in the teaching?

• A. Take the medication with meals
• B. Increase fluids while on this medication
• C. Take it only at night
• D. Report any yellowing of the skin

Correct answer: B

Rationale: The correct answer is B: 'Increase fluids while on this medication.' Amitriptyline can cause side effects like dry mouth and urinary retention. Increasing fluids can help alleviate these side effects. Choices A, C, and D are incorrect. Taking the medication with meals or only at night is not specifically related to managing the side effects of amitriptyline. Reporting yellowing of the skin is important but not directly related to the side effects of this medication.

3. What is an appropriate parenting technique for time-out disciplining in children with mental health issues?

• A. Provide positive reinforcement for minor infractions
• B. Remove all privileges for at least one week following a violation
• C. Limit the child's time outside of the home environment
• D. Time-out should only be used in severe situations

Correct answer: B

Rationale: The correct answer is B: 'Remove all privileges for at least one week following a violation.' When dealing with children with mental health issues, it is essential to have consistent consequences for their actions. Providing positive reinforcement for minor infractions (choice A) may not effectively address inappropriate behaviors that require disciplinary action. Limiting the child's time outside the home environment (choice C) does not directly address the behavioral issue. Using time-out only in severe situations (choice D) may not provide consistent consequences for the child's behavior and can lead to escalation before interventions are used.

4. A healthcare provider orders a medication dose three times higher than usual. What is the nurse's first step?

• A. Administer the medication but monitor the patient closely.
• B. Verify the dosage with the prescribing provider.
• C. Administer a lower dose to minimize the risk.
• D. Hold the medication and wait for further clarification.

Correct answer: B

Rationale: The correct answer is B: Verify the dosage with the prescribing provider. When faced with an unusual medication dose, the nurse's initial action should be to confirm the order with the healthcare provider who prescribed it. This step is crucial to prevent medication errors and ensure patient safety. Choices A, C, and D are incorrect because administering the medication without clarification, administering a lower dose without approval, or holding the medication without consulting the provider can all pose risks to the patient's well-being.

5. A nurse is discussing organ donation with a newly licensed nurse. Which of the following statements should the nurse include in the teaching?

• A. To donate organs, a client must provide consent prior to death
• B. The transplant team will harvest the organs for donation from the donor client
• C. During admission, all clients over the age of 18 should be asked about their organ donor status
• D. The National Organ Transplant Act prohibits the sale and purchase of organs

Correct answer: C

Rationale: The correct answer is C. Asking clients over 18 about their organ donation status upon admission is essential to ensure their wishes are respected. Option A is incorrect because organ donation requires consent, not harvesting. Option B is incorrect because the transplant team, not the donor client's provider, is responsible for organ retrieval. Option D is incorrect because the National Organ Transplant Act prohibits the commercialization of organ transactions, not their donation.

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