Nursing Elites

1. Which patient action indicates a good understanding of the nurse�s teaching about the use of an insulin pump?

• A. The patient programs the pump for an insulin bolus after eating
• B. The patient changes the location of the insertion site every week
• C. The patient takes the pump off at bedtime and starts it again each morning.
• D. The patient plans for a diet that is less flexible when using the insulin pump.

Correct answer: A

Rationale:

2. When a client who is in pain refuses to be repositioned, what should the nurse consider first in making a decision about what to do?

• A. Why a decision is needed.
• B. Who actually gets to make the decision?
• C. What are the alternatives?
• D. When a decision is needed.

Correct answer: A

Rationale: In this scenario, the nurse should first consider why a decision is needed. Understanding the underlying reason for the decision helps in selecting the best action to meet the desired goal. Who actually makes the decision is important but not the primary consideration. Exploring alternatives comes after determining the reason for the decision, who makes it, and when it is needed.

3. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?

• A. Document the surgeon's instructions in the client's medical record.
• B. Complete an incident report.
• C. Consult the charge nurse.
• D. Notify the nursing manager.

Correct answer: D

Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.

4. A nurse is admitting a new client. Which of the following actions should the nurse take while performing medication reconciliation?

• A. Compare the client's home medications with the provider's prescriptions
• B. Place the client's home medication bottles in a secure location
• C. Call the pharmacy to determine whether the client's medications are available
• D. Verify the client's name on their identification bracelet with the medication administration record

Correct answer: A

Rationale: The correct answer is A. During medication reconciliation, the nurse should compare the client's home medications with the provider's prescriptions to ensure accurate and safe administration. This process helps identify any discrepancies or potential interactions. Choice B is incorrect because placing the client's home medication bottles in a secure location is not part of medication reconciliation. Choice C is incorrect as calling the pharmacy to determine medication availability is not related to reconciling medications. Choice D is incorrect as verifying the client's name on their identification bracelet with the medication administration record is part of the identification process, not medication reconciliation.

5. Which of the following best describes the concept of patient-centered care?

• A. Care that is directed solely by healthcare providers
• B. Care that involves coordination among multiple healthcare providers
• C. Care that prioritizes the patient's preferences, needs, and values
• D. Care that strictly adheres to the latest clinical guidelines

Correct answer: C

Rationale: Patient-centered care is a healthcare approach that places the patient at the center of decision-making, emphasizing their preferences, needs, and values. This approach ensures that care is tailored to individual patients, taking into account their unique circumstances and actively involving them in their own care. Choice A is incorrect because patient-centered care focuses on the patient's needs rather than being solely directed by healthcare providers. Choice B is incorrect as involving multiple healthcare providers doesn't necessarily mean care is patient-centered; instead, it's about tailoring care to the patient's individual needs. Choice D is also incorrect as patient-centered care goes beyond just following clinical guidelines to encompass individual patient preferences and values.

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