Nursing Elites

1. A client who reports insomnia is being taught by a nurse about promoting rest and sleep. Which statement should indicate to the nurse that the client understands the instructions?

• A. I will walk briskly for 30 minutes before bedtime
• B. I will have a cup of hot cocoa immediately before bedtime
• C. I will no longer have a glass of wine before bedtime
• D. I will do my muscle relaxation techniques each afternoon

Correct answer: C

Rationale: The correct answer is C because avoiding alcohol before bedtime can help promote better sleep. Choice A is incorrect as vigorous exercise close to bedtime can actually hinder sleep. Choice B is also incorrect as consuming beverages with caffeine or sugar close to bedtime can disrupt sleep. Choice D, while a good practice, does not directly address the issue of avoiding alcohol before bedtime to improve sleep quality.

2. A client in her first trimester of pregnancy is being taught by a nurse about over-the-counter medications that belong to pregnancy risk category B. Which of the following medications should the nurse include?

• A. Naproxen
• B. Aspirin
• C. Ibuprofen
• D. Acetaminophen

Correct answer: D

Rationale: Acetaminophen is the correct choice as it belongs to pregnancy risk category B, making it considered safe during pregnancy. Naproxen, Aspirin, and Ibuprofen are not recommended during pregnancy, especially in the first trimester, as they are classified in higher-risk categories which may be harmful to the developing fetus.

3. A nurse is caring for a client who is postoperative and refuses to use an incentive spirometer following major abdominal surgery. Which of the following actions is the nurse's priority?

• A. Demonstrate how to use the spirometer
• B. Set a realistic postoperative goal
• C. Determine the reasons why the client is refusing
• D. Request that a respiratory therapist discuss the technique

Correct answer: C

Rationale: The priority action for the nurse is to determine the reasons why the client is refusing to use the incentive spirometer. By understanding the client's concerns or issues, the nurse can address them effectively, provide education or support, and encourage the client to comply with the necessary postoperative care. This approach fosters a patient-centered care environment. Demonstrating how to use the spirometer (Choice A) may be important but is not the priority at this moment. Setting a realistic postoperative goal (Choice B) is relevant but not as immediate as understanding the client's refusal. Requesting a respiratory therapist (Choice D) can be considered later if needed, but the nurse's initial focus should be on understanding the client's perspective.

4. A nurse manager is discussing electronic medical records with a newly licensed nurse. Which of the following actions should the nurse take to maintain client confidentiality?

• A. Log out of the computer terminal before leaving.
• B. Share passwords for computer access with colleagues.
• C. Change computer access passwords on a regular basis.
• D. Avoid accessing information about clients admitted to other units.

Correct answer: A

Rationale: The correct answer is A: Log out of the computer terminal before leaving. Logging out before leaving the computer terminal is crucial to ensuring patient data remains confidential and to prevent unauthorized access. Choice B is incorrect because sharing passwords compromises confidentiality. Choice C is incorrect as changing passwords regularly, although a good practice for security, is not directly related to maintaining client confidentiality. Choice D is incorrect as it does not address the immediate concern of maintaining client confidentiality through proper access to electronic medical records.

5. While working the night shift, a nurse observes a colleague behaving strangely. What is the best course of action?

• A. Ignore the behavior and continue working
• B. Report the behavior to the supervisor
• C. Ask the colleague if everything is okay
• D. Discuss the behavior with other colleagues

Correct answer: B

Rationale: When a nurse observes a colleague behaving strangely, the best course of action is to report the behavior to the supervisor. Unusual behavior by a healthcare professional could compromise patient safety and should be addressed promptly. Ignoring the behavior (Choice A) could potentially lead to negative outcomes for patients. Asking the colleague directly (Choice C) may not be appropriate if the behavior poses a risk. Discussing the behavior with other colleagues (Choice D) may not directly address the issue and could lead to gossip rather than a resolution.

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