Nursing Elites

1. What is the initial action a healthcare provider should take for a patient with chest pain?

• A. Administer oxygen
• B. Administer nitroglycerin
• C. Administer morphine
• D. Prepare for surgery

Correct answer: A

Rationale: The correct initial action for a patient with chest pain is to administer oxygen. Chest pain can be caused by insufficient oxygenation, and providing oxygen helps alleviate the pain by increasing oxygen levels in the blood. Administering nitroglycerin or morphine may be appropriate based on the underlying cause of the chest pain, but oxygen should be given first to ensure the patient's oxygen supply is adequate. Surgery is not typically the initial intervention for chest pain.

2. A nurse overhears two assistive personnel (AP) discussing care for a client in the elevator. What action should the nurse take?

• A. Contact the client's family about the incident.
• B. Notify the client's provider about the incident.
• C. File a complaint with the ethics committee.
• D. Report the incident to the AP's charge nurse.

Correct answer: D

Rationale: The correct action for the nurse to take in this situation is to report the incident to the AP's charge nurse. This ensures that the issue is addressed internally and allows for proper handling of the situation. Contacting the client's family about the incident (Choice A) may not be appropriate as it could breach confidentiality and escalate the situation unnecessarily. Notifying the client's provider (Choice B) is not the most immediate and effective step to address the issue. Filing a complaint with the ethics committee (Choice C) should be reserved for serious ethical violations, and in this case, reporting to the charge nurse is the more practical and immediate course of action.

3. A nurse is providing dietary teaching to a client with irritable bowel syndrome. Which of the following recommendations should the nurse include?

• A. Consume foods high in bran fiber.
• B. Increase intake of milk products.
• C. Sweeten foods with fructose corn syrup.
• D. Increase intake of foods high in gluten.

Correct answer: A

Rationale: The correct answer is A: Consume foods high in bran fiber. Bran fiber helps alleviate symptoms of irritable bowel syndrome by promoting regular bowel movements. Choice B is incorrect as increasing intake of milk products may exacerbate symptoms in some individuals with irritable bowel syndrome who are lactose intolerant. Choice C is incorrect as fructose corn syrup may worsen symptoms due to its high fructose content, which can be poorly absorbed in some individuals with irritable bowel syndrome. Choice D is incorrect as increasing foods high in gluten may be problematic for individuals with irritable bowel syndrome who have gluten sensitivity or celiac disease.

4. A nurse is caring for a client who is 2 hours postoperative following a cholecystectomy. Which of the following actions should the nurse take to prevent postoperative complications?

• A. Instruct the client to perform deep breathing and coughing exercises.
• B. Have the client wear sequential compression devices (SCDs).
• C. Place the client in a supine position with the head of the bed flat.
• D. Encourage the client to ambulate every 2 hours.

Correct answer: B

Rationale: The correct answer is B: Have the client wear sequential compression devices (SCDs). Following a cholecystectomy, the client is at risk for venous thromboembolism (VTE) due to reduced mobility and surgical stress. SCDs help prevent VTE by promoting venous return and reducing the risk of blood clots. Choices A, C, and D are incorrect. While deep breathing and coughing exercises are essential postoperatively, SCDs take precedence in preventing VTE. Placing the client in a supine position with the head of the bed flat can increase the risk of respiratory complications. Encouraging ambulation is important, but SCDs are a higher priority in this situation to prevent VTE.

5. A nurse is caring for a client who is receiving oxytocin to augment labor. The client's contractions are occurring every 2 minutes with a duration of 90 seconds. Which of the following actions should the nurse take?

• A. Increase the oxytocin infusion.
• B. Maintain the oxytocin infusion.
• C. Discontinue the oxytocin infusion.
• D. Provide reassurance to the client.

Correct answer: C

Rationale: The correct action for the nurse to take in this situation is to discontinue the oxytocin infusion. With contractions occurring every 2 minutes and lasting 90 seconds, this pattern indicates hyperstimulation, which can be harmful to the fetus. Discontinuing the oxytocin infusion is essential to prevent further harm. Increasing the oxytocin infusion would exacerbate the situation, maintaining it would continue the risk, and providing reassurance to the client, although important, does not address the need for immediate action to ensure the safety of the fetus.

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