Nursing Elites

1. If a nurse administers an incorrect dose of medication, which fact related to the incident report should the nurse document in the client's medical record?

• A. Time the medication was given
• B. The client's response to the medication
• C. The dose that was administered
• D. Reason for the error

Correct answer: A

Rationale: The correct answer is to document the time the medication was given. This is essential for understanding the sequence of events surrounding the medication error. While documenting the client's response to the medication (Choice B) is important for assessing any effects, the immediate concern should be to establish a clear timeline by documenting the time of administration. Recording the dose administered (Choice C) is also important, but in the context of understanding the incident, the time factor takes precedence. The reason for the error (Choice D) should be included in the incident report but may not be the first priority when documenting in the client's medical record.

2. How should a healthcare professional educate a patient on the use of an incentive spirometer?

• A. Instruct the patient to take deep breaths
• B. Instruct the patient to cough forcefully
• C. Instruct the patient to blow into the spirometer
• D. Instruct the patient to use the spirometer every hour

Correct answer: D

Rationale: Instructing the patient to use the spirometer every hour is crucial for optimal lung expansion and to prevent postoperative pulmonary complications. This regular use helps to keep the lungs clear and maintain their capacity. Choices A, B, and C are incorrect because deep breathing, forceful coughing, and blowing into the spirometer do not specifically address the proper use of the incentive spirometer, which is essential for postoperative respiratory recovery.

3. What is the initial step when a patient is experiencing chest pain?

• A. Administer oxygen
• B. Reposition the patient
• C. Provide pain relief
• D. Provide nitroglycerin

Correct answer: A

Rationale: Administering oxygen is the initial step in managing chest pain. Oxygen helps improve oxygenation levels in the blood, which is crucial in cases of chest pain. Repositioning the patient, providing pain relief, or administering nitroglycerin may be necessary steps depending on the underlying cause, but administering oxygen takes precedence as it addresses the primary concern of oxygen supply to the body during chest pain.

4. A healthcare professional is preparing to administer an autologous blood product to a client. Which of the following actions should the healthcare professional take to identify the client?

• A. Match the client's identification band with the number on the blood unit
• B. Confirm the provider's prescription matches the number on the blood component
• C. Ask the client to state their blood type and confirm the date of their last blood donation
• D. Ensure that the client's identification band matches the number on the blood unit

Correct answer: D

Rationale: Ensuring that the client's identification band matches the number on the blood unit is crucial for correct identification. This action helps prevent errors by confirming that the blood product is indeed intended for the specific client. Matching the client's blood type with type and cross-match specimens (Choice A) is important for compatibility but does not directly verify the client's identity. Confirming the provider's prescription (Choice B) is relevant but does not ensure the correct identification of the client. Asking the client to state their blood type and confirm the date of their last blood donation (Choice C) relies on the client's memory and verbal confirmation, which may not be accurate or reliable for identification purposes.

5. A client is being taught about the use of hypnosis during labor. Which of the following statements is appropriate?

• A. Hypnosis focuses on biofeedback as a relaxation technique
• B. Hypnosis promotes increased control of pain perception during contractions
• C. Hypnosis uses therapeutic touch to reduce anxiety during labor
• D. Hypnosis provides instruction to minimize pain

Correct answer: B

Rationale: The correct answer is B because hypnosis during labor aims to increase control over pain perception, helping manage labor pain without the need for medication. Choice A is incorrect as hypnosis doesn't primarily focus on biofeedback. Choice C is incorrect because hypnosis doesn't rely on therapeutic touch. Choice D is incorrect because hypnosis doesn't just provide instructions to minimize pain but rather helps individuals gain control over their pain perception.

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