Nursing Elites

1. A nurse manager is presenting to a group of unit nurses the categories regulated under the Controlled Substances Act. Which of the following medications should the nurse include under Schedule II?

• A. Buprenorphine hydrochloride
• B. Hydrocodone bitartrate
• C. Diazepam
• D. Morphine

Correct answer: B

Rationale: The correct answer is B: Hydrocodone bitartrate. According to the Controlled Substances Act, hydrocodone bitartrate is classified as a Schedule II controlled substance due to its high potential for abuse and addiction. Diazepam (Choice C) and morphine (Choice D) are classified as Schedule IV and Schedule II controlled substances, respectively. Buprenorphine hydrochloride (Choice A) is classified as a Schedule III controlled substance. Therefore, hydrocodone bitartrate should be included under Schedule II medications when discussing the categories regulated under the Controlled Substances Act.

2. Which action by a nurse demonstrates effective communication with a patient?

• A. Providing the patient with written information about their care.
• B. Maintaining eye contact and listening actively to the patient.
• C. Using medical jargon to explain the patient's condition.
• D. Speaking with the patient in a hurried manner to save time.

Correct answer: B

Rationale: Maintaining eye contact and actively listening to the patient is crucial in effective communication as it helps build rapport, shows empathy, and ensures that the patient feels heard and understood. Providing written information can be helpful, but the direct interaction is essential for effective communication. Using medical jargon may confuse the patient instead of clarifying their condition. Speaking hurriedly can make the patient feel rushed and not valued, hindering effective communication.

3. A client with diabetes mellitus is prescribed prednisone for a rash. Which statement by the client indicates the need for further teaching?

• A. I might have trouble falling asleep while taking prednisone
• B. I might feel emotional when I am on this medicine
• C. I might need to increase my regular insulin during this time
• D. I will gradually stop the prednisone when my rash goes away

Correct answer: D

Rationale: The correct answer is D. Prednisone should never be stopped abruptly; it must be tapered down. Stopping it suddenly can lead to adrenal insufficiency. Choices A, B, and C are all potential side effects or considerations when taking prednisone and do not indicate a need for further teaching.

4. A nurse is caring for a client who is requesting to leave the facility against medical advice (AMA). The client states, 'I am ready to go immediately.' Which of the following actions should the nurse take first?

• A. Teach the client about the potential health risks of leaving early
• B. Ask the client to sign a document stating they are leaving AMA
• C. Document the client's statement in direct quotes in the medical record
• D. Complete an incident report detailing the client scenario

Correct answer: A

Rationale: The correct action for the nurse to take first is to educate the client about the potential health risks of leaving against medical advice (AMA). By providing this information, the nurse can help the client make an informed decision regarding their healthcare. Choice B, asking the client to sign a document, can be done after the client has been informed about the risks. Choice C, documenting the client's statement, is important but should not take precedence over educating the client. Choice D, completing an incident report, is not the priority when a client is requesting to leave AMA.

5. What is the primary purpose of turning and repositioning an immobile patient every 2 hours?

• A. To improve circulation and relieve pressure.
• B. To prevent contractures and muscle atrophy.
• C. To prevent skin breakdown and pressure ulcers.
• D. To improve respiratory function and prevent pneumonia.

Correct answer: C

Rationale: The primary purpose of turning and repositioning an immobile patient every 2 hours is to prevent skin breakdown and pressure ulcers. Prolonged immobility can lead to pressure ulcers, making this a crucial nursing intervention. Choice A is incorrect because while turning can help improve circulation and relieve pressure, the primary purpose is to prevent skin breakdown. Choice B is incorrect as preventing contractures and muscle atrophy is important but not the primary purpose of turning. Choice D is incorrect as improving respiratory function and preventing pneumonia are not directly related to turning and repositioning for skin integrity.

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