Nursing Elites

1. How should a healthcare provider manage a patient with a history of hypertension who is non-compliant with medication?

• A. Educate the patient on the importance of medication
• B. Reassess the patient in 6 months
• C. Refer the patient to a specialist
• D. Discontinue the medication

Correct answer: A

Rationale: Educating the patient on the importance of medication is crucial when dealing with a patient who is non-compliant with their hypertension medication. By providing information about the significance of the medication in controlling blood pressure and preventing complications, the patient may be more motivated to adhere to the prescribed treatment. Reassessing the patient in 6 months (choice B) may lead to further deterioration of the patient's condition if non-compliance continues. Referring the patient to a specialist (choice C) may be necessary in some cases but should be preceded by efforts to improve compliance. Discontinuing the medication (choice D) without addressing the non-compliance issue can have serious health consequences for the patient.

2. A healthcare professional is preparing to administer packed red blood cells (PRBCs) to a client. Which of the following actions should the healthcare professional take?

• A. Infuse the PRBCs over 8 hours.
• B. Verify the client's blood type and Rh factor.
• C. Administer the PRBCs through a 24-gauge catheter.
• D. Administer the PRBCs with lactated Ringer's solution.

Correct answer: B

Rationale: Verifying the client's blood type and Rh factor is crucial before administering blood products to ensure compatibility and prevent adverse reactions. Option A is incorrect because PRBCs are typically infused over a specific time frame based on hospital policy and client condition, not necessarily over 8 hours. Option C is incorrect as PRBCs are usually administered through a larger gauge catheter to prevent hemolysis. Option D is incorrect because PRBCs are typically administered with normal saline and not lactated Ringer's solution.

3. A charge nurse is educating a group of unit nurses about delegating client tasks to assistive personnel. Which of the following statements should the nurse make?

• A. The nurse is legally responsible for the actions of the AP.
• B. An AP can perform tasks outside of their scope if they have been trained.
• C. An experienced AP can delegate tasks to another AP.
• D. An RN evaluates the client's needs to determine tasks to delegate.

Correct answer: D

Rationale: The correct statement is D: 'An RN evaluates the client's needs to determine which tasks are appropriate to delegate to assistive personnel.' This is an essential step in the delegation process to ensure that tasks are assigned appropriately based on the client's condition and the competencies of the assistive personnel. Option A is incorrect because while the nurse retains accountability for delegation decisions, the AP is responsible for their actions. Option B is incorrect as tasks should be within the AP's scope of practice regardless of training. Option C is incorrect as delegation typically involves assigning tasks from the RN to the AP, not between APs.

4. A nurse is planning care for a client who is receiving hemodialysis. What action should the nurse include in the plan?

• A. Withhold all medications until after dialysis.
• B. Rehydrate with dextrose 5% in water for orthostatic hypotension.
• C. Check the vascular access site for bleeding after dialysis.
• D. Give an antibiotic 30 minutes before dialysis.

Correct answer: C

Rationale: The correct action that the nurse should include in the plan for a client receiving hemodialysis is to check the vascular access site for bleeding after dialysis. This is important to prevent complications such as infection or excessive bleeding. Withholding all medications until after dialysis (Choice A) is not necessary unless specific medications need to be avoided due to the dialysis process. Rehydrating with dextrose 5% in water for orthostatic hypotension (Choice B) is not directly related to post-dialysis care. Giving an antibiotic 30 minutes before dialysis (Choice D) is not a standard practice unless there is a specific clinical indication.

5. A client who has a prescription for insulin glargine is talking to a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will mix this insulin with my regular insulin before injecting it.
• B. I will store this insulin in the refrigerator after opening it.
• C. I will take this insulin twice a day.
• D. I will inject this insulin when my blood glucose is above 200 mg/dL.

Correct answer: B

Rationale: The correct answer is B because insulin glargine should be stored in the refrigerator after opening to maintain its potency. Choice A is incorrect as insulin glargine should not be mixed with other insulins. Choice C is incorrect because insulin glargine is typically taken once a day. Choice D is incorrect because insulin glargine is usually taken regardless of blood glucose levels.

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