Nursing Elites

1. An RN is making assignments for client care to an LPN at the beginning of the shift. Which of the following assignments should the LPN question?

• A. Assisting a client who is 24 hr postop to use an incentive spirometer
• B. Collecting a clean catch urine specimen from a client who was admitted on the previous shift
• C. Providing nasopharyngeal suctioning for a client who has pneumonia
• D. Replacing the cartridge and tubing on a PCA pump

Correct answer: D

Rationale: The LPN should question the assignment of replacing the PCA pump cartridge and tubing as it is outside the LPN's scope of practice. LPNs are not trained to handle tasks related to PCA pumps, which involve medication administration and monitoring that are typically within the RN's responsibilities. Assisting a postop client with an incentive spirometer (Choice A), collecting a clean catch urine specimen (Choice B), and providing nasopharyngeal suctioning for a client with pneumonia (Choice C) are all tasks that fall within the LPN's scope of practice and do not require questioning by the LPN.

2. A nurse is caring for a client who is 2 hours postoperative following a colon resection. Which of the following assessments is the nurse's priority?

• A. Capillary refill
• B. Bowel sounds
• C. Temperature
• D. Oxygen saturation

Correct answer: D

Rationale: The correct answer is D: Oxygen saturation. The priority assessment in this situation is oxygen saturation because postoperative clients are at risk for respiratory complications, such as hypoxia due to factors like anesthesia effects, impaired lung function, or pain interfering with deep breathing. Monitoring oxygen saturation is crucial to detect any respiratory compromise early. Capillary refill, bowel sounds, and temperature are important assessments but are not the priority in this immediate postoperative period.

3. A nurse is caring for a client who is constipated. What intervention is most appropriate?

• A. Administer a laxative to relieve discomfort
• B. Encourage the client to increase dietary fiber intake
• C. Encourage the client to rest until symptoms resolve
• D. Administer a stool softener as prescribed

Correct answer: B

Rationale: The most appropriate intervention for constipation is to encourage the client to increase dietary fiber intake. Fiber helps promote bowel movements and relieve constipation by adding bulk to the stool. Administering a laxative (Choice A) should not be the first-line intervention as it can lead to dependence. Encouraging rest (Choice C) is not directly helpful in relieving constipation. While administering a stool softener (Choice D) can be beneficial, increasing fiber intake is generally preferred as the initial intervention.

4. What should a healthcare provider monitor in a client with constipation?

• A. Monitor the client's bowel sounds every 4 hours
• B. Increase the client's activity to stimulate bowel movement
• C. Encourage the client to use a stool softener
• D. Encourage the client to rest in bed until constipation resolves

Correct answer: C

Rationale: Encouraging the client to use a stool softener is the appropriate intervention for constipation. Stool softeners help to soften the stool, making it easier to pass and relieving constipation without straining the client. Monitoring bowel sounds (Choice A) may be relevant for other gastrointestinal issues but is not specifically indicated for constipation. Increasing activity (Choice B) can be helpful in some cases, but it is not the first-line intervention for constipation. Encouraging bed rest (Choice D) can worsen constipation by reducing mobility and promoting inactivity.

5. A client has a prescription for ciprofloxacin. Which of the following instructions should the nurse include?

• A. Take the medication with an antacid if you experience gastrointestinal upset.
• B. You should limit your caffeine intake while taking this medication.
• C. This medication may cause your urine to turn dark brown.
• D. You should avoid taking this medication with dairy products.

Correct answer: D

Rationale: The correct answer is D: 'You should avoid taking this medication with dairy products.' Ciprofloxacin should not be taken with dairy products as they can interfere with the absorption of the medication. Choice A is incorrect because ciprofloxacin should not be taken with antacids containing aluminum or magnesium. Choice B is incorrect as there is no specific limitation on caffeine intake associated with ciprofloxacin. Choice C is incorrect as ciprofloxacin does not typically cause urine to turn dark brown.

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