Nursing Elites

1. In orienting new staff nurses to a pediatric intensive care unit, what is an important consideration in providing information to parents of a critically ill child?

• A. Making sure they receive complete information during each encounter
• B. Assessing parents' preferences regarding the amount of information
• C. Allowing parents to observe key aspects of their child's care
• D. Providing patient education brochures explaining ICU protocols

Correct answer: B

Rationale: Assessing parents' preferences about the amount of information is crucial because it allows for individualized care that respects their needs and emotional capacity during a stressful time. Choice A is not ideal as overwhelming parents with complete information during each encounter may not align with their preferences. Choice C, while valuable, may not always be feasible or appropriate due to privacy concerns or medical procedures. Choice D, providing brochures, may not address the specific needs or preferences of each set of parents, making it less effective than assessing individual preferences.

2. A nurse is providing discharge teaching to a client who is starting to take carbidopa/levodopa to treat Parkinson’s disease. Which of the following instructions should the nurse include in the teaching?

• A. “This medication can cause your urine to turn a dark color.”
• B. “Expect immediate relief after taking this medication.”
• C. “Take the medication with a high-protein food.”
• D. “Skip a dose of the medication if you experience dizziness.”

Correct answer: A

Rationale: The correct instruction the nurse should provide is that the medication can cause the client's urine to turn a dark color, which is a harmless effect of carbidopa/levodopa. This is due to the metabolites of levodopa. Immediate relief is not expected after taking the medication because it may take weeks to months to achieve the full therapeutic effect. Taking the medication with a high-protein food is not recommended as protein can interfere with the absorption of levodopa. Skipping a dose of the medication if the client experiences dizziness is incorrect as dizziness may be a side effect of the medication, and doses should not be skipped without consulting a healthcare provider.

3. A nurse is caring for a client receiving corticosteroids. Which of the following should the nurse monitor?

• A. Blood glucose levels
• B. Blood pressure
• C. Serum potassium levels
• D. Both A and B

Correct answer: D

Rationale: When a client is receiving corticosteroids, the nurse should monitor both blood glucose levels and blood pressure. Corticosteroids can elevate blood glucose levels, leading to hyperglycemia, and may cause hypertension. Monitoring these parameters is essential to detect and address any potential adverse effects promptly. While monitoring serum potassium levels is important in some situations, it is not a primary concern when caring for a client receiving corticosteroids. Therefore, choices A and B are the most appropriate options for monitoring in this scenario, making option D the correct answer.

4. A nurse is preparing to administer a dose of insulin. Which of the following should the nurse do first?

• A. Check the expiration date
• B. Verify the client's blood glucose level
• C. Obtain the client's weight
• D. Assess for signs of hypoglycemia

Correct answer: B

Rationale: The correct answer is to verify the client's blood glucose level first before administering insulin. This step is crucial to determine the appropriate dose of insulin based on the client's current blood glucose level. Checking the expiration date (Choice A) is important but not the first step in this scenario. Obtaining the client's weight (Choice C) is not directly related to the immediate administration of insulin. Assessing for signs of hypoglycemia (Choice D) should be done after administering insulin to monitor for potential side effects or adverse reactions.

5. A nurse enters a patient's room and finds the client pulseless. The living will requests no resuscitation be performed, but the provider has not written the prescription. What action should the nurse take?

• A. Notify the family.
• B. Begin CPR.
• C. Await further instructions from the provider.
• D. Document the event.

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to begin CPR. Even though the living will requests no resuscitation, without a written do-not-resuscitate (DNR) order from the provider, the nurse is ethically and legally bound to initiate CPR to provide life-saving measures until further confirmation is obtained. Notifying the family (Choice A) may cause a delay in providing immediate care. Waiting for further instructions (Choice C) can be time-consuming and compromise patient outcomes. Documenting the event (Choice D) is important but should follow after initiating CPR to ensure patient safety and adherence to protocols.

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