Nursing Elites

1. After completion of mandatory counseling, the impaired nurse has asked nursing administration to allow return to work. When the nurse administrator approaches the charge nurse with the impaired nurse’s request, what action is best for the charge nurse to take?

• A. Ask to meet with the impaired nurse’s therapist before allowing the nurse back on the unit
• B. Meet with staff to assess their feelings about the impaired nurse’s return to the unit
• C. Since treatment is completed, assign the nurse to routine RN responsibilities
• D. Allow the impaired nurse to return to work and monitor medication administration

Correct answer: D

Rationale: Allowing the impaired nurse to return to work with monitoring is the best course of action in this scenario. By monitoring the impaired nurse's medication administration, the charge nurse can ensure safe practice while supporting the nurse's reintegration into the work environment. Meeting with the therapist (Choice A) is not within the charge nurse's scope of responsibility and may violate the impaired nurse's privacy. Assessing staff feelings (Choice B) is important but should be done by leadership, not the charge nurse. Simply assigning routine duties (Choice C) may not address the need for monitoring and support required in this situation.

2. A client with metastatic breast cancer refuses to participate in a clinical trial and further treatments. Her children ask the nurse to convince their mother to reconsider. How should the nurse respond?

• A. Ask the client if she fully understands the decision she has made with her children present.
• B. Discuss the success of clinical trials and ask the client to consider participating for one month.
• C. Explain to the family that they must accept their mother’s decision.
• D. Explore the client’s decision to refuse treatment and offer support.

Correct answer: D

Rationale: The correct response is to explore the client's decision to refuse treatment and offer support. In this situation, it is crucial for the nurse to respect the client's autonomy and decisions regarding her own health. By exploring the client's reasons for refusal, the nurse can better understand her perspective and provide appropriate support. Option A is incorrect as it focuses on questioning the client in front of her children, potentially pressuring her. Option B is inappropriate as it disregards the client's autonomy and tries to persuade her to participate. Option C is also incorrect as it dismisses the client's decision and fails to address the family's concerns in a supportive manner.

3. A male client with hypercholesterolemia wants to change his diet to help reduce his cholesterol levels. Which breakfast items should the nurse encourage the client to eat? (Select all that apply)

• A. Sausage patties and eggs
• B. Whole wheat toast and jam
• C. Bagels and cream cheese
• D. Blackberries and oatmeal

Correct answer: B

Rationale: The correct choices are whole wheat toast and jam (B) and blackberries and oatmeal (D). Whole wheat toast and blackberries are high in fiber, which can help lower cholesterol levels. Sausage patties and eggs (A) are high in saturated fats that can raise cholesterol levels. Bagels and cream cheese (C) are not as beneficial for cholesterol control compared to high-fiber options like whole wheat toast and blackberries.

4. A client who is diagnosed with amyotrophic lateral sclerosis (ALS) is having difficulty swallowing and articulating words. Which intervention is most important to include in this client’s plan of care?

• A. Encourage speaking slowly and articulating words
• B. Sit upright and flex chin forward while swallowing
• C. Position a communication board at the bedside
• D. Provide feeding utensils with large grip handles

Correct answer: B

Rationale: The correct intervention for a client with ALS experiencing difficulty swallowing and articulating words is to sit upright and flex the chin forward while swallowing. This position helps manage dysphagia associated with ALS by facilitating the swallowing process. Encouraging speaking slowly and articulating words (Choice A) may be helpful for speech clarity but does not address the swallowing issue. Positioning a communication board (Choice C) would not directly address the swallowing difficulty. Providing feeding utensils with large grip handles (Choice D) is not the priority intervention for managing dysphagia in ALS.

5. When conducting diet teaching for a client who is on a postoperative full liquid diet, which foods should the nurse encourage the client to eat?

• A. Vanilla frozen yogurt
• B. Vegetable juice
• C. Clear beef broth
• D. Canned fruit cocktail

Correct answer: A

Rationale: The correct answer should be provided as choice E: Vanilla frozen yogurt. For a postoperative full liquid diet, the nurse should encourage the client to eat foods that are fully liquid and easy to digest. Vanilla frozen yogurt is a suitable choice as it provides calories and nutrients while being in a liquid form. Creamy peanut butter, vegetable juice, and canned fruit cocktail are not appropriate for a full liquid diet as they are not fully liquid and may not be easy to digest. Creamy peanut butter is solid, vegetable juice is not fully liquid, and canned fruit cocktail contains solid pieces.

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