Nursing Elites

1. The staff nurse delegates AM care for two patients to the UAP (Unlicensed Assistive Person). What principle of delegation is the nurse following?

• A. Delegation requires a situation with clearly defined superiors.
• B. Delegation can only exist with a subordinate.
• C. Delegation is a tool used by various healthcare professionals.
• D. You can delegate only those tasks.

Correct answer: D

Rationale: The correct answer is D: 'You can delegate only those tasks.' Delegation in nursing involves transferring responsibility for the performance of a task while retaining accountability for the outcome. The principle of delegation does not require a situation with clearly defined superiors (choice A). Delegation can exist not only with a subordinate but also with colleagues or other healthcare team members (choice B). Delegation is not exclusive to nurses and is a tool used by various healthcare professionals (choice C). Therefore, the best choice is D as it accurately reflects the principle of delegation in nursing.

2. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

3. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

4. Nonverbal messages in communication, including body language and environmental factors, are called ___________.

• A. lateral communication
• B. upward communication
• C. metacommunications
• D. downward communication

Correct answer: C

Rationale: Nonverbal messages in communication, such as body language and environmental factors, are termed metacommunications. Choice A, lateral communication, refers to communication between individuals or groups on the same hierarchical level. Choice B, upward communication, involves the flow of information from lower levels to higher levels in an organization. Choice D, downward communication, relates to the transmission of information from higher levels to lower levels within an organization. Therefore, the correct term for nonverbal messages in communication is metacommunications.

5. When someone is consistently late for work due to unreliable transportation, this is known as which type of barrier?

• A. Attendance
• B. Voluntary
• C. Motivation
• D. Involuntary

Correct answer: A

Rationale: The correct answer is 'Attendance.' In this scenario, the nurse being late for work due to unreliable transportation is an example of an attendance barrier. This type of barrier refers to factors that affect an individual's ability to be present at work on time, such as transportation issues. Choices B, C, and D are incorrect because voluntary barriers are ones that individuals choose to impose on themselves, motivation barriers relate to lacking the drive to perform a task, and involuntary barriers are obstacles beyond one's control.

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