Nursing Elites

1. A nurse is developing a plan of care for an older adult who is at risk for falls. Which of the following actions should the nurse include?

• A. Lock beds and wheelchairs when not in use
• B. Administer a sedative at bedtime
• C. Provide information about home safety checks
• D. Teach balance and strengthening exercises

Correct answer: A

Rationale: The correct action for the nurse to include in the plan of care for an older adult at risk for falls is to lock beds and wheelchairs when not in use. This measure is crucial for preventing falls and ensuring patient safety in healthcare settings. Administering sedatives at bedtime (Choice B) is not recommended as it does not address the underlying risk factors for falls and may increase the risk of injury. Providing information about home safety checks (Choice C) is important for fall prevention in the home environment but is not directly related to healthcare settings. Teaching balance and strengthening exercises (Choice D) is beneficial for fall prevention but may not be suitable for all older adults at risk for falls, especially in acute care settings.

2. A client with severe dyspnea is scheduled for multiple diagnostic tests. Which test should the nurse prioritize?

• A. Administer an echocardiogram first.
• B. Prioritize a chest x-ray for the client.
• C. Prepare the client for a CT scan.
• D. Order an MRI first.

Correct answer: B

Rationale: The correct answer is B: Prioritize a chest x-ray for the client. When a client presents with severe dyspnea, a chest x-ray should be prioritized as it helps in assessing the lungs and heart, which are crucial in cases of respiratory distress. Echocardiograms are more focused on assessing heart function and may not provide immediate information needed in cases of dyspnea. CT scans and MRIs are more detailed imaging studies that are not typically the first-line diagnostic tests for severe dyspnea.

3. When a patient refuses to remove their religious jewelry before surgery, what is the best response for the nurse preparing for the procedure?

• A. Proceed with the surgery and document the refusal.
• B. Ask the patient for permission to secure the jewelry safely.
• C. Tape the jewelry to the patient's body during surgery.
• D. Tell the patient they must remove the jewelry for safety reasons.

Correct answer: B

Rationale: The best response for the nurse is to ask the patient for permission to secure the jewelry safely. Hospital policy typically requires jewelry to be secured or removed to prevent interference during surgery. Proceeding with the surgery without addressing the issue or taping the jewelry to the patient's body are not safe practices and can lead to complications during the procedure. Directing the patient to remove the jewelry without exploring alternative solutions is not patient-centered care and may create unnecessary tension.

4. A nurse is caring for a client who has an ethical conflict about the care she is receiving. Which of the following resources should the nurse consult about resolving the dilemma?

• A. Hospital ethics committee
• B. Quality improvement committee
• C. Chaplain
• D. Director of nursing

Correct answer: A

Rationale: The correct answer is the hospital ethics committee. This committee is specifically designed to address and resolve ethical conflicts in patient care. It comprises professionals from various disciplines who can provide guidance and support in navigating ethical dilemmas. Choice B, the quality improvement committee, focuses on enhancing the quality of care provided but may not be equipped to handle ethical conflicts. Choice C, the chaplain, offers spiritual and emotional support but may not have the expertise to resolve ethical dilemmas. Choice D, the director of nursing, is responsible for nursing operations and may not be the appropriate resource for addressing ethical conflicts.

5. A healthcare professional is giving a change-of-shift report about a client admitted earlier that day with pneumonia. Which of the following pieces of information is the priority for the healthcare professional to provide?

• A. Recent chest x-ray results
• B. Medication history
• C. Breath sounds
• D. Lab results

Correct answer: C

Rationale: The correct answer is C: 'Breath sounds.' When providing a change-of-shift report for a client with pneumonia, the priority information to communicate is the assessment of breath sounds. Monitoring breath sounds is crucial in assessing respiratory status and the effectiveness of treatments in pneumonia. Option A, recent chest x-ray results, may be important but does not provide real-time information on the client's current status. Option B, medication history, is relevant but not as immediate as assessing breath sounds. Option D, lab results, can provide valuable information but may not be as urgent as monitoring the client's respiratory status through breath sounds.

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