Nursing Elites

1. A nurse is caring for an older adult client. The nurse informs the client that straining while defecating can cause which of the following?

• A. Diarrhea
• B. Gastric ulcer
• C. Dilated pupils
• D. Dysrhythmias

Correct answer: D

Rationale: The correct answer is D: Dysrhythmias. Straining while defecating can lead to dysrhythmias due to increased vagal stimulation. Choices A, B, and C are incorrect. Straining while defecating is not typically associated with causing diarrhea, gastric ulcers, or dilated pupils.

2. A nurse is teaching an older adult client who has left-sided weakness about cane use. Which of the following instructions should the nurse include?

• A. Hold the cane with your left hand
• B. Move the cane forward 18 inches with each step
• C. When walking, move your left foot forward first
• D. Keep your elbow straight when you hold the cane

Correct answer: C

Rationale: The correct instruction for a client with left-sided weakness using a cane is to move the left foot forward first. This technique helps improve stability and safety by ensuring weight-bearing on the stronger side while providing support with the cane. Choice A is incorrect because the cane should be held on the stronger side, which is the right side in this case. Choice B is incorrect as the recommended distance to move the cane forward with each step is about 6 inches, not 18 inches. Choice D is incorrect as it is essential to maintain a slight bend in the elbow while using the cane to absorb shock and provide flexibility.

3. A staff nurse is challenging a shift assignment with the charge nurse. Which of the following statements made by the charge nurse is an example of smoothing as a strategy to resolve conflict?

• A. If you accept this assignment today, I will let you choose your assignment tomorrow
• B. If you don't agree with the assignment, I will have to report your decision to the nursing supervisor
• C. Let's just focus on giving our client medications on time
• D. You have a lot of experience, so I'm sure you're capable of these tasks

Correct answer: D

Rationale: The correct answer is D because it exemplifies smoothing as a conflict resolution strategy. Smoothing involves downplaying conflict and reassuring the individual to reduce tension. In this statement, the charge nurse acknowledges the staff nurse's experience and capability to perform the assigned tasks, which aims to reduce conflict and promote a positive outlook. Choices A, B, and C do not reflect smoothing. Choice A involves a conditional agreement, choice B introduces a threat of reporting, and choice C shifts the focus away from the conflict.

4. When caring for a client's tracheostomy at home, which instruction should the nurse include in the teaching?

• A. Clean with alcohol
• B. Cover the tracheostomy when outside
• C. Replace the tube weekly
• D. Use tap water to clean

Correct answer: B

Rationale: Covering the tracheostomy when outside is crucial as it helps prevent dust and other irritants from entering the airway, reducing the risk of complications. Cleaning with alcohol (choice A) can be too harsh for the skin around the tracheostomy site. While replacing the tube weekly (choice C) is important, it is typically done by healthcare providers. Using tap water to clean (choice D) is not recommended as it may introduce contaminants to the tracheostomy site.

5. A nurse is caring for a patient who is postoperative day 1 following abdominal surgery. What is the nurse's priority action to prevent complications?

• A. Encourage the patient to perform incentive spirometry.
• B. Assist the patient in ambulating around the unit.
• C. Reposition the patient every 2 hours.
• D. Administer pain medication as prescribed.

Correct answer: A

Rationale: The correct answer is to encourage the patient to perform incentive spirometry. Incentive spirometry helps prevent respiratory complications, such as atelectasis, by promoting deep breathing and optimal lung expansion. Ambulating, repositioning, and administering pain medication are important interventions but do not take precedence over preventing respiratory complications in the immediate postoperative period.

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