Nursing Elites

1. The nurse is working with families who have been displaced by a fire in an apartment complex. What is the priority intervention during the initial assessment?

• A. Provide a liaison to meet housing needs.
• B. Attentively listen when clients describe their feelings.
• C. Offer nurturing support for clients who are confused by the events.
• D. Provide structure for clients exhibiting moderate to severe anxiety.

Correct answer: A

Rationale: The correct answer is to provide a liaison to meet housing needs. In the initial assessment after a disaster like a fire, ensuring basic needs such as housing, clothing, and food are met is the priority. Once the physical needs are addressed, the nurse can then focus on assisting clients in managing the psychological effects of loss. Choices B, C, and D are not the priority during the initial assessment as addressing housing needs should come first to provide a sense of stability and security for the affected families.

2. Activities of effective supervisors can be task-related or people-related activities. An example of a task-related supervisory activity is:

• A. coaching.
• B. evaluating.
• C. delegating.
• D. facilitating.

Correct answer: C

Rationale: Delegating is the act of assigning work to those capable and competent to do the work, making it a task-related supervisory activity. Coaching, evaluating, and facilitating are people-related supervisory activities. Coaching involves guiding and developing individuals, evaluating entails assessing performance, and facilitating focuses on enabling tasks and processes. These activities are more centered on interacting with and supporting people rather than directly assigning tasks. Therefore, in the context of task-related activities, delegating stands out as the correct choice.

3. While assessing a client who is dying for signs of impending death, what should the nurse observe for?

• A. Elevated blood pressure
• B. Cheyne-Stokes respiration
• C. Elevated pulse rate
• D. Decreased temperature

Correct answer: B

Rationale: When assessing a client for signs of impending death, the nurse should observe for Cheyne-Stokes respiration. This pattern involves rhythmic waxing and waning of respirations from very deep breathing to very shallow breathing with periods of temporary apnea. It is often associated with cardiac failure and can be a significant indicator of impending death. Elevated blood pressure and pulse rate are not typical signs of impending death; in fact, they may indicate other conditions. A decreased temperature is also not a common sign of impending death, as temperature changes can vary among individuals and may not always correlate with the dying process.

4. A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:

• A. naloxone (Narcan).
• B. labetalol (Normodyne).
• C. neostigmine (Prostigmin).
• D. thiothixene (Navane).

Correct answer: A

Rationale: When a client becomes extremely somnolent with respiratory depression after being given an opiate drug, the physician is likely to order the administration of naloxone (Narcan). Naloxone is an opiate antagonist that attaches to opiate receptors, blocking or reversing the action of narcotic analgesics. Choices B, C, and D are incorrect. Labetalol is a beta blocker used for hypertension, neostigmine is an anticholinesterase agent used to treat myasthenia gravis and reverse neuromuscular blockade, and thiothixene is an antipsychotic agent used for psychiatric conditions.

5. The nurse is participating in discharge teaching for the postpartal client. The nurse is aware that an effective means of managing discomfort associated with an episiotomy after discharge is:

• A. Promethazine
• B. Aspirin
• C. Sitz baths
• D. Ice packs

Correct answer: C

Rationale: A sitz bath is an effective method for managing discomfort associated with an episiotomy after discharge. It helps reduce swelling and promotes healing in the perineal area. Ice packs (option D) are typically used immediately after delivery to provide pain relief. Promethazine (option A) and aspirin (option B) are not indicated for managing discomfort associated with an episiotomy. Promethazine is an antihistamine, and aspirin is a nonsteroidal anti-inflammatory drug, both of which are not commonly used for this purpose.

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