Nursing Elites

1. A nurse manager is preparing to complete staff performance appraisals. Which of the following principles should the nurse manager consider when completing the appraisals?

• A. Performance appraisals should be written in measurable terms
• B. Appraisal objectives should be applicable to staff at every level
• C. Performance appraisals should be based on the nurse manager's preferences
• D. Completed appraisals should be approved by a provider

Correct answer: A

Rationale: Corrected Rationale: Performance appraisals should indeed be written in measurable terms to ensure objective evaluations based on specific outcomes achieved. This allows for a clear assessment of staff performance. Choice B is incorrect because appraisal objectives should be tailored to each staff member's role and responsibilities, not necessarily applicable at every level. Choice C is incorrect as performance appraisals should be objective and based on predefined criteria, not solely on the nurse manager's preferences. Choice D is incorrect as completed appraisals usually require approval from higher-level management or HR, not necessarily a provider.

2. Which of the following is an adverse effect of Lithium Carbonate that requires client education?

• A. Increased risk of infection
• B. Gastrointestinal distress
• C. Increased white blood cell count
• D. Nausea and vomiting

Correct answer: B

Rationale: The correct answer is B: Gastrointestinal distress. When taking Lithium Carbonate, clients may experience gastrointestinal distress as an adverse effect. It is crucial to educate clients about this potential side effect to help them manage it effectively. Choices A, C, and D are incorrect. Increased risk of infection (Choice A) is not a typical adverse effect of Lithium Carbonate. Similarly, increased white blood cell count (Choice C) is not associated with this medication's adverse effects. Nausea and vomiting (Choice D) are general side effects of many medications but are not specifically attributed to Lithium Carbonate.

3. Which factor places a patient at the highest risk for infection?

• A. A healthy immune system
• B. Presence of chronic illness
• C. Being well-nourished
• D. Age over 65 years

Correct answer: B

Rationale: The presence of chronic illness is the factor that places a patient at the highest risk for infection. Chronic illness can compromise the immune system's ability to fight off infections effectively, making individuals more susceptible to getting sick. Option A, a healthy immune system, actually reduces the risk of infection. Option C, being well-nourished, can support overall health but does not directly correlate with infection risk. While age over 65 years is a risk factor for certain infections due to age-related immune system changes, chronic illness has a more significant impact on infection risk.

4. A client has a new prescription for beclomethasone inhaler to use with an albuterol inhaler for asthma maintenance. What should the nurse instruct the client?

• A. Skip doses if breathing improves
• B. Use the albuterol inhaler first
• C. Gargle with water after each use
• D. Store inhaler in the refrigerator

Correct answer: C

Rationale: The correct answer is to instruct the client to gargle with water after each use of the beclomethasone inhaler. Beclomethasone can cause oral thrush, and gargling with water helps prevent this complication. Choice A is incorrect because the client should not skip doses even if breathing improves, as the medications are prescribed for maintenance. Choice B is incorrect as there is no specific instruction to use the albuterol inhaler first in this scenario. Choice D is incorrect because inhalers should not be stored in the refrigerator unless specified by the manufacturer.

5. Which of the following is a common manifestation of opioid withdrawal?

• A. Bradycardia and hypotension
• B. Tremors and increased blood pressure
• C. Severe muscle weakness and fatigue
• D. Severe hallucinations and delusions

Correct answer: B

Rationale: The correct answer is B: Tremors and increased blood pressure. During opioid withdrawal, individuals commonly experience symptoms such as tremors, increased blood pressure, and restlessness. Choice A, which suggests bradycardia and hypotension, is incorrect as opioid withdrawal often leads to tachycardia (rapid heart rate) and increased blood pressure. Choice C, severe muscle weakness and fatigue, is not a typical manifestation of opioid withdrawal. Choice D, severe hallucinations and delusions, is more characteristic of conditions like delirium tremens associated with alcohol withdrawal, rather than opioid withdrawal.

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