Nursing Elites

1. When managing time effectively, which of the following stimuli should the nurse respond to first?

• A. the physician's loud verbal direction
• B. the nursing supervisor who is going to a meeting
• C. unit staff leaving on a break
• D. the care needs of the returning postoperative client just exiting the elevator

Correct answer: D

Rationale: The correct answer is to attend to the care needs of the returning postoperative client just exiting the elevator first. In a healthcare setting, patient care should always take precedence, especially for complex or unstable clients requiring immediate assessment and care. The physician's loud verbal direction, the nursing supervisor going to a meeting, and unit staff leaving on a break are important but do not involve direct patient care. Therefore, the nurse should prioritize responding to the returning postoperative client to ensure their immediate needs are met.

2. During the change of shift, the oncoming nurse notes a discrepancy in the number of Percocet (Oxycodone) listed and the number present in the narcotic drawer. The nurse's first action should be to:

• A. Notify the hospital pharmacist
• B. Notify the nursing supervisor
• C. Notify the Board of Nursing
• D. Notify the director of nursing

Correct answer: B

Rationale: The first action the nurse should take is to report the finding to the nursing supervisor and follow the chain of command. Notifying the nursing supervisor allows for immediate action within the facility to address the discrepancy. If it is found that the pharmacy is in error, then notifying the hospital pharmacist (Choice A) would be appropriate. Choices C and D, notifying the Board of Nursing and the director of nursing, are not the initial steps to take. These options may be necessary if theft is suspected or if the facility's internal response is inadequate. Therefore, they are incorrect answers.

3. A Roman Catholic client is preparing to have magnetic resonance imaging. He wants to wear his metal crucifix pendant while he is receiving the test. Which of the following is an appropriate response by the nurse?

• A. "Because it gives you comfort, you may wear it."?
• B. "It is a violation of religious rights to forbid it."?
• C. "I am sorry, but it is not safe for you to wear the crucifix during this test."?
• D. "You may wear it because it is important to you."?

Correct answer: C

Rationale: No metal objects may be worn while receiving magnetic resonance imaging due to safety risks involved with the strong magnet. The correct response by the nurse should prioritize the safety of the client. Allowing the client to wear the metal crucifix poses a risk of injury or interference with the imaging process. Option A is not appropriate as safety takes precedence over comfort in this situation. Option B is incorrect as it does not address the safety concerns associated with wearing metal objects during an MRI. Option D is also incorrect as it fails to acknowledge the safety issue involved and instead focuses solely on the importance to the client. It is important for the nurse to offer alternative forms of spiritual support that do not pose a risk during the MRI procedure.

4. While taking care of a client, the nurse thinks that physical therapy in the hospital might be beneficial to their condition. The following is the ideal referral process EXCEPT?

• A. Transport the client to the physical therapy room for treatment after receiving an official referral.
• B. Provide the physical therapist with the client's medical record after the referral.
• C. Contact the client's primary care provider to suggest a physical therapy referral.
• D. Request the client to self-refer to the physical therapist.

Correct answer: D

Rationale: The ideal referral process for a client to receive physical therapy in the hospital starts with the nurse contacting the client's primary care provider to discuss and suggest a physical therapy referral. The primary care provider should provide an official referral, which is crucial for initiating the treatment process. After obtaining the official referral, the nurse should provide the physical therapist with the client's medical record. This step is essential for the therapist to assess the client's condition and customize the treatment plan accordingly. Once the physical therapist is informed and prepared, the nurse can then transport the client to the physical therapy room for treatment. Therefore, the correct sequence is to first contact the primary care provider (Choice C), then provide the medical record (Choice B), and finally transport the client for treatment (Choice A). Choice D, suggesting the client self-refer to the physical therapist, is incorrect as the referral process should involve healthcare professionals to ensure proper assessment and treatment planning.

5. When working with elderly clients, the healthcare provider should keep in mind that falls are most likely to happen to the elderly who are:

• A. in their 80s.
• B. living at home.
• C. hospitalized.
• D. living on only Social Security income.

Correct answer: C

Rationale: The correct answer is 'hospitalized.' Elderly individuals are at a higher risk of falls, especially when they are in new environments like hospitals due to unfamiliarity with the surroundings, medications, and potential mobility challenges. Being in a hospital can disrupt their usual routines and increase the risk of falls. Choice A ('in their 80s') is not as directly related to the increased risk of falls in a hospital environment. Choice B ('living at home') is a common setting for the elderly but does not address the specific risk associated with being hospitalized. Choice D ('living on only Social Security income') is unrelated to the risk of falls based on the environment.

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