Thursday, 21 September 2017

Q. A dehydrated 3 year old has vomited three times in the last hour and continues to have frequent diarrhea. The child was admitted 2 days ago with gastroenteritis caused by rotavirus. The child weighs 22 kg, has a normal saline lock in the right hand, and has had 30 ml of urine output in the last 4 hours. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse calls the primary healthcare provider with a recommendation for:

A. Giving a dose of loperaminde (Immodium).
B. Starting a fluid bolus of normal saline.
C. Beginning an intravenous (IV) antibiotic.
D. Establishing a Foley catheter.

Correct Answer: B

Explanation: The child is dehydrated, cannot retain oral fluids, and continues to have diarrhea. A normal saline bolus should be given followed by maintenance IV fluids. Anti-diarrheal medications are not recommended for children and will prolong the illness. The child has gastroenteritis caused by a viral illness. IV antibiotics are not indicated for viral illnesses.

Wednesday, 20 September 2017

Nursing Tutorial and Material, Infant
Q. Before placement of a ventriculoperitoneal shunt for hydrocephalus, an infant is irritable, lethargic, and difficult to feed. To maintain the infant's nutritional status, which of the following actions would be most appropriate?

A. Feeding the infant just before doing any procedures.
B. Giving the infant small, frequent feedings.
C. Feeding the infant in a horizontal position.
D. Scheduling the feedings for every 6 hours.

Correct Answer: B

Explanation: An infant with hydrocephalus is difficult to feed because of poor sucking, lethargy, and vomiting, which are associated with increased intracranial pressure. Small, frequent feedings given at times when the infant is relaxed and calm are tolerated best. Feeding an infant before any procedure is inappropriate because the stress of the procedure may lead to vomiting. Ideally, the infant should be held in a slightly vertical position when feeding to prevent backflow of formula into the eustachian tubes and subsequent development of ear infections. Most infants are fed on demand every 3 to 4 hours.

Monday, 18 September 2017

Question Of The Day, The Nursing Process
Q. The nurse is assigning tasks to unlicensed assistive personnel (UAP) for a client with an abdominal hysterectomy on the first postoperative day. Which of the following can NOT be delegated to the UAP?

A. Taking vital signs.
B. Recording intake and output.
C. Giving perineal care.
D. Assessing the incision site.

Correct Answer: D

Explanation: The registered nurse is responsible for monitoring the surgical site for condition of the dressing, status of the incision, and signs and symptoms of complications. Unlicensed assistive personnel who have been trained to report abnormalities to the registered nurse supervising the care may take vital signs, record intake and output, and give perineal care.

Thursday, 14 September 2017

Q. The nurse-manager of a home health facility includes which item in the capital budget?

A. Salaries and benefits for her staff
B. A $1,200 computer upgrade
C. Office supplies
D. Client-education materials costing $300

Correct Answer: B
Explanation: Capital budgets generally include items valued at more than $500. Salaries and benefits are part of the personnel budget. Office supplies and client education materials are part of the operating budget.

Tuesday, 12 September 2017

Q. Which of the following alert the nurse to possible internal bleeding in a client who has undergone pulmonary lobectomy 2 days ago?

A. Increased blood pressure and decreased pulse and respiratory rates.
B. Sanguineous drainage from the chest tube at a rate of 50 ml/hour during the past 3 hours.
C. Restlessness and shortness of breath.
D. Urine output of 180 ml during the past 3 hours.

Correct Answer: C
Explanation: Restlessness indicates cerebral hypoxia due to decreased circulating volume. Shortness of breath occurs because blood collecting in the pleural space faster than suction can remove it prevents the lung from reexpanding. Increased blood pressure and decreased pulse and respiratory rates are classic late signs of increased intracranial pressure. Decreasing blood pressure and increasing pulse and respiratory rates occur with hypovolemic shock. Sanguineous drainage that changes to serosanguineous drainage at a rate less than 100 ml/hour is normal in the early postoperative period. Urine output of 180 ml over the past 3 hours indicates normal kidney perfusion.

Monday, 11 September 2017

Question Of The Day, Neurosensory Disorders
Q. A client is receiving an I.V. infusion of mannitol (Osmitrol) after undergoing intracranial surgery to remove a brain tumor. To determine whether this drug is producing its therapeutic effect, the nurse should consider which finding most significant?

A. Decreased level of consciousness (LOC)
B. Elevated blood pressure
C. Increased urine output
D. Decreased heart rate

Correct Answer: C
Explanation: The therapeutic effect of mannitol is diuresis, which is confirmed by an increased urine output. A decreased LOC and elevated blood pressure may indicate lack of therapeutic effectiveness. A decreased heart rate doesn't indicate that mannitol is effective.

Saturday, 9 September 2017

If you are preparing to graduate nursing school this semester or still have few semesters left, it’s always a great idea to start building your resume and add to it as you progress through your program.

Job-Seeker’s Journal: Preparing Your Resume in Nursing School
For the most effective nursing school resume, it’s best to start early.

As I embark on my final weeks of nursing school, here are some tips that I have learned while writing my resume. Remember, there are many ways to construct a resume, so it’s important to find a format that best showcases your unique achievements, skills, and experiences. Here are a few tips to help you get started:

Know what nursing recruiters look for in a resume  

Nursing recruiters are always looking for a stand-out candidate that will bring something to their nursing staff.  Before you even get an interview, nurse recruiters will evaluate you based on your resume alone, so it’s important to have a unique resume. Typically, they look for a resume that looks professional, highlights your achievements, includes your recent and relevant work history as it pertains to the position you are applying for, references, and recommendation letters from your professors and/or clinical instructors.

How to stand out from the nursing student crowd

When I first started to write my resume, I thought it was great and that it hit the major components of what should be in a resume. And then I looked at a few of my peers’ resumes and I realized they were all basically the same. Next, I found a new template to use and formatted my information accordingly. It’s important to avoid using bright colors and dizzy fonts—keep it simple and clean, so it’s easy for the nurse recruiter to read. I always have a hard time getting my resume to fit on one page, but I managed to include only the things that will help me to get the job as a nurse. Depending on who you ask, some people will say you absolutely need it on one page, and others may say that rule doesn’t stand so much today (just don’t exceed 2!).

What skills to include showcase yourself

Most importantly, make sure you have any information listed that will showcase your talents and potential as a nurse on the unit applying for. The first draft of my resume listed skills such as Microsoft Word, Excel, and PowerPoint—all great skills, but not those nursing recruiters are most interested in. I tweaked my resume to more strongly showcase my skills of working well in groups, teamwork, utilizing critical thinking, evidence based-knowledge, and incorporating QSEN (Quality and Safety Education for Nurses) into my nursing practice.

Again, one of the hardest parts of writing my resume was narrowing it down to about a page while still highlighting my skills and achievements. It’s important to look great on paper, but don’t forget the actual interview is where you will really want to shine.

Utilize your professors with letters of recommendation

With your stellar resume, nursing recruiters really want to see letters of recommendations.  I was told this in my nursing program as well, and I think it’s important to include 1-2 letters of recommendations with your resume. This is a way for nursing recruiters to hear about your work ethic and skills from someone who has worked closely with you and has seen you learn and grow.

It’s always a great idea to ask a professor that you developed a great rapport with or a clinical instructor. These are the people that have been with you day in and day out of your nursing program, and can really vouch for you as a student, person, and nurse.

Writing a resume can seem challenging, but think of it as your calling card. Many places ask you to apply by submitting your resume through the internet, and if they like what they see there, they will call you in for an interview. If you have a great resume, it helps to get your foot in the door for an interview, which will hopefully lead to a job as a registered nurse.

Friday, 8 September 2017

Question Of The Day, Immune and Hematologic Disorders
Q. A client with pernicious anemia asks why she must take vitamin B12 injections for the rest of her life. Which is the nurse's best response?

A. "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient acid."
B. "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor."
C. "The reason for your vitamin deficiency is an excessive excretion of the vitamin because of kidney dysfunction."
D. "The reason for your vitamin deficiency is an increased requirement for the vitamin because of rapid red blood cell production."

Correct Answer: B
Explanation: Most clients with pernicious anemia have deficient production of intrinsic factor in the stomach. Intrinsic factor attaches to the vitamin in the stomach and forms a complex that allows the vitamin to be absorbed in the small intestine. The stomach is producing enough acid, there is not an excessive excretion of the vitamin, and there is not a rapid production of red blood cells in this condition.




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