Nursing Elites

1. Which of the following NSAIDs is most commonly used for a brief period for acute pain?

• A. Advil
• B. Aleve
• C. Toradol
• D. Bextra

Correct answer: C

Rationale: Toradol is the correct answer because it is an NSAID known for its effectiveness in managing acute pain for short durations. It can be administered via intramuscular (IM), intravenous (IV), or oral (PO) routes. Advil (choice A) and Aleve (choice B) are commonly used for mild to moderate pain but may not be as effective for acute pain requiring immediate relief. Bextra (choice D) was withdrawn from the market due to safety concerns, making it an inappropriate choice for acute pain management.

2. A nurse monitoring a client with a chest tube notes that there is no tidaling of fluid in the water seal chamber. After further assessment, the nurse suspects that the client's lung has reexpanded and notifies the healthcare provider. The healthcare provider verifies with the use of a chest x-ray that the lung has reexpanded, then calls the nurse to ask that the chest tube be removed. Which action should the nurse take first?

• A. Explain the procedure to the client, then remove the chest tube.
• B. Call the nursing supervisor.
• C. Inform the healthcare provider that removal of a chest tube is not a nursing procedure.
• D. Obtain petrolatum-impregnated gauze and ask another nurse to assist in removing the chest tube.

Correct answer: C

Rationale: The correct action for the nurse to take first is to inform the healthcare provider that removal of a chest tube is not a nursing procedure. Actual removal of a chest tube is the duty of a healthcare provider. If the healthcare provider insists that the nurse remove the tube, the nurse must contact the nursing supervisor. Some agencies' policies and procedures may permit an advanced practice nurse to remove a chest tube, but there is no information in the question to indicate that the nurse is an advanced practice nurse. Choice A is incorrect because the nurse should not proceed with removing the chest tube without proper authorization. Choice B is incorrect as calling the nursing supervisor should come after clarifying with the healthcare provider. Choice D is incorrect as the nurse should not begin the process of removing the chest tube without proper guidance and authorization.

3. Which of these would be the most appropriate way to document a client's refusal of medication?

• A. "Heparin refused during shift. Risks reviewed."?
• B. "The client refused the heparin injection when I tried to administer it. She yelled at me, saying, 'I do not want that injection right now!' and told me to leave the room. I explained the risks of not taking the medication. She seemed very annoyed that I tried to give it at that time. I will attempt again later in my shift."?
• C. "Subcutaneous Heparin injection was attempted to be given to the client per the physician's order. Client refused, stating, 'I do not want that injection.' Potential risks for refusing the medication were reviewed with the client, and the client verbalized understanding."?
• D. "Ct stated she did not want the SQ heparin inj at this time. Risks of not taking this med were reviewed with the ct, and the ct verbalized understanding."?

Correct answer: C

Rationale: The most appropriate way to document a client's refusal of medication should include details such as the medication, the client's statement of refusal, and the review of potential risks. Choice C accurately captures all these essential elements, making it the correct answer. Choice A lacks details about the client's refusal and the review of risks. Choice B includes unnecessary emotional descriptions and a plan of action that might not be appropriate. Choice D uses abbreviations that may not be universally understood, lacks proper punctuation, and also does not provide a detailed account of the refusal and the review of risks.

4. All of the following interventions should be performed when fetal heart monitoring indicates fetal distress except:

• A. increase maternal fluids
• B. administer oxygen
• C. decrease maternal fluids
• D. turn the mother

Correct answer: C

Rationale: When fetal distress is indicated, interventions are aimed at improving oxygenation and blood flow to the fetus. Increasing maternal fluids helps improve blood flow and oxygen delivery, administering oxygen increases oxygenation levels, and turning the mother can help optimize fetal oxygenation. Decreasing maternal fluids would negatively impact blood volume and can worsen fetal distress, making it the exception among the listed interventions. Therefore, decreasing maternal fluids should not be performed when fetal distress is present.

5. A nurse discusses staff empowerment with the nursing team. The nurse explains that staff empowerment has which function?

• A. Fosters the growth of others so that they are less dependent on the leader
• B. Means that the staff has the power to reprimand and punish any individual who is not meeting the standards of care delivery
• C. Indicates that the nurse leader will make decisions regarding the nursing unit and expects that the staff will comply with the changes
• D. Allows the staff to make every decision regarding employee scheduling

Correct answer: A

Rationale: Staff empowerment fosters the growth of others and facilitates their development so that they are less dependent on their leader. This empowerment is about enhancing skills and autonomy, not about reprimanding or punishing others (Choice B). Empowerment involves shared decision-making and autonomy, not unilateral decision-making by the leader (Choice C). Moreover, staff empowerment does not mean that staff should make every decision regarding operational aspects like employee scheduling (Choice D). It is primarily focused on developing individuals' capabilities and fostering independence within the team.

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