Nursing Elites

1. The nurse is teaching a client with newly diagnosed type 1 diabetes about insulin administration. Which statement by the client indicates a need for further teaching?

• A. I will rotate my injection sites to avoid lipodystrophy.
• B. I will check my blood sugar before meals and at bedtime.
• C. I will use the same needle for 3 days if I keep it clean.
• D. I will keep my insulin refrigerated until I need it.

Correct answer: C

Rationale: The correct answer is C because insulin needles should be disposed of after a single use to prevent infection. Reusing the same needle for three days can lead to infection and is not a safe practice. Choices A, B, and D demonstrate good understanding of insulin administration and diabetes management, so they do not indicate a need for further teaching.

2. A client with herpes zoster asks the nurse about using complementary and alternative therapies for pain control. The nurse should inform the client that this condition is a contraindication for which of the following therapies?

• A. Biofeedback
• B. Aloe
• C. Feverfew
• D. Acupuncture

Correct answer: D

Rationale: Acupuncture is contraindicated for clients with herpes zoster due to the risk of introducing an open portal on the skin, which can increase the risk of infection. This therapy involves inserting needles into specific points on the body, potentially causing skin trauma and providing a route for the virus to spread. Biofeedback, aloe, and feverfew are not contraindicated for clients with herpes zoster and can be considered for pain management in this condition. Biofeedback involves using electronic devices to help individuals learn to control physiological processes, aloe is a plant known for its skin-soothing properties, and feverfew is an herb that has been used for pain relief.

3. A charge nurse on an acute care unit is planning care for a client. Which of the following actions should the nurse take to promote the client’s continuity of care?

• A. Plan to assign the client a different nurse each shift
• B. Limit the number of interdisciplinary team members involved in managing the client’s care
• C. Request that the client complete a satisfaction survey at discharge
• D. Start discharge planning on the day of admission

Correct answer: D

Rationale: Starting discharge planning on the day of admission is crucial to ensuring a smooth transition and continuity of care for the client. It allows for early identification of needs, coordination of services, and timely interventions. Assigning a different nurse each shift (Choice A) can disrupt continuity of care and lead to inconsistencies in the client's treatment. Limiting the number of interdisciplinary team members (Choice B) may hinder comprehensive care coordination. Requesting a satisfaction survey at discharge (Choice C) focuses more on feedback rather than proactive care planning and coordination.

4. A nurse is caring for a competent adult client who tells the nurse, 'I am leaving the hospital this morning whether the doctor discharges me or not.' The nurse believes that this is not in the client’s best interest and prepares to administer a PRN sedative medication the client has not requested along with the scheduled morning medication. Which of the following types of tort is the nurse about to commit?

• A. Assault
• B. False imprisonment
• C. Negligence
• D. Breach of confidentiality

Correct answer: B

Rationale: The nurse is about to commit false imprisonment by unlawfully restricting the client's freedom of movement. In this scenario, the nurse's actions of preparing to administer sedative medication against the client's will in an effort to prevent them from leaving the hospital constitute false imprisonment. Assault (choice A) involves the threat of bodily harm, which is not present here. Negligence (choice C) refers to a breach in the duty of care, which is not the primary issue in this situation. Breach of confidentiality (choice D) involves disclosing confidential information without consent, which is unrelated to the scenario described.

5. A nurse is preparing change of shift report after the night shift using one SBAR communication tool. Which of the following data should the nurse include when reporting background information?

• A. “Blood pressure 160/92 mm Hg”
• B. “Start the first dose of penicillin at 1200”
• C. “Pain rating of 5 on a scale from 0 to 10”
• D. “Code status: do-not-resuscitate”

Correct answer: B

Rationale: The correct answer is B. When providing background information in a shift report using the SBAR communication tool, the nurse should include details related to medication administration and orders. This helps ensure continuity of care and accurate handover of responsibilities. Choices A, C, and D do not typically fall under background information for shift reports. A blood pressure reading, pain rating, and code status are more relevant to the patient's current condition and status, rather than background information about medications or orders.

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