Nursing Elites

1. Constant reports of inadequate pain control in clients indicate which of the following?

• A. Improper administration of medications
• B. Potential substance abuse by the healthcare provider
• C. Poorly written prescriptions
• D. Inadequate scheduling by healthcare providers

Correct answer: B

Rationale: Constant reports of inadequate pain control may suggest potential substance abuse by the healthcare provider, as they might be diverting narcotics for personal use instead of administering them to clients. The incorrect choices include: A) Improper administration of medications may cause inadequate pain control but does not necessarily involve substance abuse. C) Poorly written prescriptions could lead to medication errors but are less likely to be related to substance abuse. D) Inadequate scheduling by healthcare providers might affect pain management but does not directly suggest substance abuse.

2. A nurse manager is preparing the budget for the year. The budgeted amounts have been set without regard to changes that may occur during the year. What type of budget is the manager preparing?

• A. Fixed budget
• B. Zero-based budget
• C. Variable budget
• D. Operating budget

Correct answer: A

Rationale: The correct answer is A: Fixed budget. A fixed budget is one where the budgeted amounts are set without considering changes that may occur during the year. This type of budget is based on the assumption that the business environment will remain stable. Choice B, Zero-based budget, involves setting the budget at zero and justifying all expenses. Choice C, Variable budget, adjusts based on changes in activity levels. Choice D, Operating budget, is a comprehensive projection of all revenue and expenses for the upcoming period.

3. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?

• A. Carefully assess and document client status.
• B. Ensure all patient information is secure and the nurse has logged out of the computer before leaving the computer station.
• C. Keep detailed notes while providing care to ensure accurate documentation later in the day.
• D. Discuss safety needs with clients.

Correct answer: A

Rationale: The correct answer is A: 'Carefully assess and document client status.' When dealing with confused clients, it is crucial to assess their status carefully and document it accurately. This helps in avoiding charges of negligence and false imprisonment by ensuring that the client's condition is well-documented and appropriate care is provided. Choice B is incorrect because it focuses on computer security rather than client care. Choice C is incorrect because it emphasizes detailed notes for accuracy but does not specifically address the confusion of clients. Choice D is incorrect as it mentions discussing safety needs but does not directly relate to avoiding charges of negligence and false imprisonment for confused clients.

4. A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?

• A. Amitriptyline decreases the depression caused by your foot pain.
• B. Amitriptyline helps prevent transmission of pain impulses to the brain.
• C. Amitriptyline corrects some of the blood vessel changes that cause pain.
• D. Amitriptyline improves sleep and reduces awareness of nighttime pain.

Correct answer: B

Rationale: The correct answer is B. Amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, which helps in reducing the transmission of pain impulses to the brain. Choice A is incorrect because amitriptyline primarily works on pain transmission rather than directly on depression. Choice C is inaccurate as amitriptyline's mechanism of action is not related to correcting blood vessel changes. Choice D is partially true as amitriptyline can improve sleep, but the primary mechanism related to pain relief is by preventing pain impulses from reaching the brain.

5. When utilizing an internal float pool, which of the following pools is most efficient?

• A. Centralized
• B. Flexible
• C. Mixed
• D. Decentralized

Correct answer: A

Rationale: Centralization is the most efficient option when utilizing an internal float pool because it allows for a pool of nurses to be used anywhere in the hospital. In centralized pools, staff members are not limited to working for only one nurse manager or on only one unit, unlike in decentralized pools. Flexible and mixed pools may offer some advantages, but in terms of efficiency and utilization of resources, centralized pools are the most effective choice.

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