Nursing Elites

1. A patient is admitted with signs of stroke. Which of the following diagnostic tests should the nurse anticipate as the priority?

• A. CT scan
• B. MRI
• C. X-ray
• D. Ultrasound

Correct answer: A

Rationale: A CT scan is the priority diagnostic test to identify and confirm the location and severity of a stroke.

2. When caring for a patient with a colostomy, which nursing action is most important?

• A. Monitor the colostomy for signs of infection.
• B. Empty the colostomy bag when it is half full.
• C. Encourage the patient to eat smaller, more frequent meals.
• D. Apply a skin barrier to prevent irritation.

Correct answer: B

Rationale: Emptying the colostomy bag when it is half full is the most important nursing action when caring for a patient with a colostomy. This practice helps prevent leakage, reduces the risk of skin irritation, and promotes patient comfort. Monitoring for signs of infection (Choice A) is essential but not as crucial as maintaining proper colostomy care. Encouraging the patient to eat smaller, more frequent meals (Choice C) can be beneficial for colostomy patients but is not as critical as ensuring timely emptying of the colostomy bag. Applying a skin barrier to prevent irritation (Choice D) is important, but ensuring timely emptying of the colostomy bag takes precedence in preventing complications associated with a colostomy.

3. A nurse manager is teaching a group of employees about standards for Quality and Safety Education for Nurses (QSEN). Which of the following statements by an employee should the nurse manager identify as an example of the QSEN concept of quality improvement?

• A. We should start tracking how soon clients are discharged after laparoscopic versus open surgery.
• B. We should involve our clients' partners in care planning as much as possible.
• C. We should be sure to log out of the computers immediately following documentation.
• D. We should provide change-of-shift report as a team, including the assistive personnel who assisted with care.

Correct answer: B

Rationale: Involving partners in care planning is a quality improvement strategy that aligns with QSEN principles. This choice reflects patient-centered care and collaboration, which are essential elements of quality improvement. Choices A, C, and D do not directly relate to quality improvement concepts. Tracking discharge times, logging out of computers, and providing change-of-shift reports are important practices but not specifically focused on quality improvement.

4. Which intervention is essential when caring for a patient with a nasogastric (NG) tube?

• A. Suction the NG tube every 4 hours.
• B. Check the placement of the NG tube before each feeding.
• C. Flush the NG tube with water before and after each medication administration.
• D. Remove the NG tube once the patient feels comfortable.

Correct answer: B

Rationale: Checking the placement of the NG tube before each feeding is crucial to ensure it is correctly positioned and safe to use. Option A is incorrect as routine suctioning can lead to complications and should only be done as needed. Option C is not necessary unless there are specific instructions for flushing. Option D is incorrect as the NG tube should only be removed by healthcare professionals based on medical criteria, not solely based on the patient's comfort.

5. What is the priority action when a patient is experiencing an allergic reaction to a medication?

• A. Monitor the patient's blood pressure every 15 minutes.
• B. Discontinue the medication and notify the healthcare provider.
• C. Administer an antihistamine to reduce symptoms.
• D. Monitor the patient's urine output closely.

Correct answer: B

Rationale: The correct answer is to discontinue the medication and notify the healthcare provider when a patient is experiencing an allergic reaction to a medication. This action is crucial to prevent further harm to the patient. Monitoring blood pressure (choice A) or urine output (choice D) may be important but is not the priority when managing an allergic reaction. Administering an antihistamine (choice C) should only be done after discontinuing the medication and consulting with the healthcare provider.

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