Nursing Elites

1. During a home safety assessment, a nurse is evaluating a client who is receiving supplemental oxygen. Which observation should the nurse identify as a proper safety protocol?

• A. The client has a weekly inspection checklist for oxygen equipment.
• B. The client stores an extra oxygen tank on its side under their bed.
• C. The client identifies the location of a fire extinguisher.
• D. The client uses a wool blanket on their bed.

Correct answer: A

Rationale: The correct answer is A because having a weekly inspection checklist for oxygen equipment ensures that the client can monitor the safety and functionality of the oxygen equipment regularly. This is crucial for maintaining a safe environment. Choice B is incorrect because storing an extra oxygen tank on its side under the bed can pose a safety hazard, as tanks should be stored upright. Choice C is a good safety practice, but it is not directly related to oxygen use. Choice D is incorrect because wool blankets are flammable and should not be used by clients receiving supplemental oxygen due to the increased risk of fire.

2. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

3. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?

• A. Document the surgeon's instructions in the client's medical record.
• B. Complete an incident report.
• C. Consult the charge nurse.
• D. Notify the nursing manager.

Correct answer: D

Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.

4. A 34-year-old has a new diagnosis of type 2 diabetes. The nurse will discuss the need to schedule a dilated eye exam

• A. every 2 years
• B. as soon as possible
• C. when the patient is 39 years old
• D. within the first year after diagnosis

Correct answer: B

Rationale: The correct answer is 'B' - as soon as possible. Patients with type 2 diabetes should have a dilated eye exam shortly after diagnosis to check for any signs of diabetic retinopathy, a common complication of diabetes. Waiting for 2 years (choice A) may lead to missing early signs of eye damage. Choice C is incorrect as there is no specific age requirement mentioned for the eye exam. Choice D is also incorrect because early detection and intervention are crucial in diabetic eye disease.

5. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: Incompetence jeopardizes patient safety. Therefore, the formal process for handling these practices should be followed.

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