Nursing Elites

1. Which intervention is most effective for managing a patient with constipation?

• A. Increase the patient's fluid intake.
• B. Administer a stool softener as prescribed.
• C. Provide the patient with a high-fiber diet.
• D. Teach the patient to perform Valsalva maneuvers.

Correct answer: B

Rationale: The most effective intervention for managing constipation in a patient is to administer a stool softener as prescribed. Stool softeners help relieve constipation by making the stool easier to pass, especially in postoperative patients. Increasing fluid intake can be beneficial but may not address the underlying cause of constipation. While a high-fiber diet is important for bowel health, it may not provide immediate relief for constipation. Teaching a patient to perform Valsalva maneuvers is not recommended for managing constipation as it can lead to adverse effects like increasing intra-abdominal pressure.

2. A nurse sees a healthcare provider administer an incorrect medication dose but does not report the error. What should the nurse do first?

• A. Ignore the situation and continue with patient care.
• B. Report the error to the nurse manager immediately.
• C. Speak to the healthcare provider directly about the error.
• D. File an anonymous report to avoid conflict.

Correct answer: B

Rationale: When a nurse witnesses a healthcare provider administering an incorrect medication dose, the first step should be to report the error to the nurse manager immediately. Reporting medication errors is crucial for patient safety as it allows prompt intervention to prevent harm. Choice A is incorrect as ignoring the situation can jeopardize patient safety. Choice C, while addressing the error directly, may not ensure proper documentation and follow-up. Choice D, filing an anonymous report, is not as effective as directly informing the nurse manager who can take appropriate action and follow-up on the incident.

3. A nurse is teaching an older adult client who reports constipation. Which of the following instructions should the nurse include in the teaching?

• A. Increase dietary intake of raw vegetables
• B. Limit activity
• C. Drink four to five glasses of water daily
• D. Bear down hard when defecating

Correct answer: C

Rationale: The correct instruction the nurse should include is to advise the client to drink four to five glasses of water daily. Increasing water intake helps alleviate constipation by softening stool and increasing bowel movements. Choice A, increasing dietary intake of raw vegetables, can be helpful in preventing constipation but may not be sufficient as the sole intervention for someone already experiencing constipation. Choice B, limiting activity, can worsen constipation as physical activity helps stimulate bowel movements. Choice D, bearing down hard when defecating, can lead to other issues like hemorrhoids and should be avoided.

4. A newly licensed nurse tells a charge nurse that he is unsure about accepting telephone medication prescriptions. Which of the following providers should the charge nurse identify as having the legal ability to give telephone medication prescriptions?

• A. Anesthesiologists
• B. Physician assistants
• C. Hospital pharmacists
• D. Nurse practitioners

Correct answer: A

Rationale: The correct answer is A: Anesthesiologists. Anesthesiologists are licensed providers who have the legal authority to give telephone medication prescriptions. Physician assistants (choice B), hospital pharmacists (choice C), and nurse practitioners (choice D) do not typically have the legal ability to provide medication prescriptions over the phone. In this scenario, the charge nurse should inform the newly licensed nurse that anesthesiologists are one of the providers who can legally give telephone medication prescriptions.

5. A healthcare provider is preparing to administer digoxin to a patient with heart failure. Which of the following lab results should be reviewed before administering the medication?

• A. Potassium level
• B. Calcium level
• C. Hemoglobin level
• D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: Potassium level. Hypokalemia increases the risk of digoxin toxicity. Digoxin can potentiate the effects of low potassium levels, leading to life-threatening arrhythmias. Therefore, it is essential to review the patient's potassium level before administering digoxin. Choices B, C, and D are incorrect because calcium level, hemoglobin level, and white blood cell count are not directly related to the risk of digoxin toxicity.

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