Nursing Elites

1. The nurse uses prioritization to determine all of the following except:

• A. time allotment for certain tasks.
• B. appropriate interventions.
• C. treatment procedures.
• D. the need for client education.

Correct answer: C

Rationale: The correct answer is C: "treatment procedures." Prioritization in nursing involves determining the order of importance or urgency of tasks. Treatment procedures are standards of care that need to be followed as defined by the facility or nursing unit. They are not typically subject to prioritization but are mandatory based on established protocols. Time allotment for certain tasks, appropriate interventions, and the need for client education are all aspects that can be influenced by prioritization. For instance, prioritizing tasks helps in managing time effectively, selecting the most suitable interventions, and identifying the necessity for client education as part of the care plan.

2. An LPN is having a conflict with another nurse during her shift. She has tried to discuss the issues with the nurse with no resolution. What is the most appropriate way for the LPN to proceed?

• A. Report the conflict to the director of nursing over the unit.
• B. Report the conflict to the assigned charge nurse of the unit.
• C. Report the conflict to the nurse manager of the unit.
• D. Discuss the conflict with the other nurse to attempt resolution of the issue.

Correct answer: B

Rationale: In this scenario, the most appropriate way for the LPN to proceed is to report the conflict to the assigned charge nurse of the unit. Following the chain of command is crucial in a professional setting to address conflicts effectively. Reporting the issue to the charge nurse, who is the immediate supervisor, allows for a structured approach to resolving the conflict. Reporting directly to higher levels such as the director of nursing or nurse manager may bypass the appropriate hierarchy and could create unnecessary tension. Attempting to resolve the issue independently with the other nurse may not be effective if previous attempts have failed, making it essential to involve the immediate supervisor.

3. For which condition might a client's antidiuretic hormone (ADH) level be increased?

• A. diabetes mellitus
• B. diabetes insipidus
• C. hypothyroidism
• D. hyperthyroidism

Correct answer: B

Rationale: The correct answer is diabetes insipidus. In this condition, the client's ADH level is increased. Diabetes insipidus is characterized by the inability of the kidneys to conserve water due to either inadequate secretion of ADH (central diabetes insipidus) or the kidneys' inability to respond to ADH (nephrogenic diabetes insipidus). Choices A, C, and D are incorrect. In diabetes mellitus, ADH levels are typically normal or elevated in response to high blood sugar levels. Hypothyroidism is not directly related to ADH secretion. In hyperthyroidism, ADH levels are usually normal or decreased.

4. What are the hazards of improper splinting?

• A. Aggravation of a bone or joint injury
• B. Reduced distal circulation
• C. Delay in transporting a client with a life-threatening injury
• D. All of the above

Correct answer: D

Rationale: Hazards of improper splinting can lead to the aggravation of a bone or joint injury, reduced distal circulation, and delay in transporting a client with a life-threatening injury. Choosing 'All of the above' (Option D) is the correct answer as it encompasses all the hazards mentioned. Option A is incorrect because it only addresses one aspect of the hazards. Option B is incorrect as it does not cover all the hazards associated with improper splinting. Option C is incorrect as it focuses on only one hazard and does not account for the others.

5. While assisting a healthcare provider in assessing a hospitalized client, the healthcare provider is paged to report to the recovery room. The healthcare provider instructs the nurse verbally to change the solution and rate of the intravenous (IV) fluid being administered. What is the most appropriate nursing action in this situation?

• A. Calling the nursing supervisor to obtain permission to accept the verbal prescription
• B. Asking the healthcare provider to write the prescription in the client's record before leaving the nursing unit
• C. Telling the healthcare provider that the prescription will not be implemented until it is documented in the client's record
• D. Changing the solution and rate of the IV fluid per the healthcare provider's verbal prescription

Correct answer: B

Rationale: Verbal prescriptions should be avoided due to the risk of errors. If a verbal prescription is necessary, it should be promptly written and signed by the healthcare provider, typically within 24 hours. Following agency policies and procedures regarding verbal prescriptions is crucial. In this scenario, the most appropriate nursing action is to request the healthcare provider to document the prescription in the client's record before leaving the unit. Calling the nursing supervisor to accept the verbal prescription without documentation, telling the healthcare provider to delay treatment until documented, and directly changing the IV fluid based on verbal orders all pose risks and do not align with best practices in medication administration.

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