Nursing Elites

1. A nurse manager wishes to ensure that the nurses on the unit are practicing at their highest levels of competency. Which areas should the manager assess to determine if the nursing staff demonstrate competency according to the Institute of Medicine (IOM) report Health Professions Education: A Bridge to Quality? (Select ONE that does not apply)

• A. Collaborating with an interdisciplinary team
• B. Implementing evidence-based care
• C. Providing family-focused care
• D. Experimenting on patients

Correct answer: D

Rationale: The Institute of Medicine (IOM) report 'Health Professions Education: A Bridge to Quality' outlines five core competencies that healthcare providers should possess. These competencies include collaborating with an interdisciplinary team, implementing evidence-based care, providing family-focused care, using informatics in practice, and focusing on patient-centered care. Therefore, to ensure that nurses are practicing at their highest levels of competency as per the IOM report, the nurse manager should assess all of these areas.

2. A client with hypertension is being taught about lifestyle modifications. Which statement by the client indicates a need for further teaching?

• A. I will reduce my sodium intake to help control my blood pressure.
• B. I need to start walking at least 30 minutes most days of the week.
• C. I can continue drinking alcohol as long as it is not in excess.
• D. I will check my blood pressure regularly at home.

Correct answer: C

Rationale: In hypertension management, it is crucial for clients to limit or avoid alcohol consumption, not just refrain from excess. Alcohol can raise blood pressure and interfere with the effectiveness of antihypertensive medications, making it a key lifestyle modification for individuals with hypertension.

3. A client reports a headache and vertigo after turning on his furnace for the first time this season. The nurse should suspect which of the following conditions?

• A. Carbon monoxide poisoning
• B. Heat stroke
• C. Hypersensitivity reaction
• D. Oxygen toxicity

Correct answer: A

Rationale: When a client reports headache and vertigo after turning on the furnace for the first time, it suggests carbon monoxide poisoning. Carbon monoxide is an odorless, colorless gas that can be released by malfunctioning heating systems. Symptoms of carbon monoxide poisoning include headache, dizziness, weakness, nausea, and confusion. It is crucial for the nurse to suspect this condition promptly to ensure the client's safety and well-being.

4. What instruction should be included when teaching a client with asthma about using a metered-dose inhaler (MDI)?

• A. Shake the inhaler well before use.
• B. Inhale rapidly while administering the medication.
• C. Administer the medication while lying down.
• D. Hold the inhaler 2 inches away from the mouth while inhaling.

Correct answer: A

Rationale: Shaking the inhaler well before use ensures that the medication is properly mixed, allowing for an accurate dose with each administration. Inhaling slowly and deeply, not rapidly, helps the medication reach the lungs effectively. The medication should be administered while sitting or standing to facilitate proper lung expansion and airflow. Holding the inhaler 2 inches away from the mouth can lead to medication loss; it should be placed directly in the mouth or used with a spacer to optimize delivery to the airways.

5. A client interested in smoking cessation is being taught by a nurse. Which statements should the nurse include in the teaching? (Select one that does not apply)

• A. Find an activity that you enjoy and will keep your hands busy.
• B. Keep snacks like potato chips on hand to nibble on.
• C. Drink at least eight glasses of water each day.
• D. Make a list of reasons for quitting smoking.

Correct answer: C

Rationale: When teaching a client interested in smoking cessation, the nurse should advise finding an activity that keeps the hands busy, keeping healthy snacks on hand, making a list of reasons for quitting smoking, and not being upset if a relapse occurs. Drinking eight glasses of water each day is a healthy habit but is not directly related to smoking cessation strategies, making it the option that does not apply in this context.

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