Saturday 28 April 2018

Question Of The Day, Infant
Q. Which of the following should the nurse use to determine achievement of the expected outcome for an infant with severe diarrhea and a nursing diagnosis of Deficient fluid volume related to passage of profuse amounts of watery diarrhea?

A. Moist mucous membranes.
B. Passage of a soft, formed stool.
C. Absence of diarrhea for a 4-hour period.
D. Ability to tolerate intravenous fluids well.

Correct Answer: A

Explanation: The outcome of moist mucous membranes indicates adequate hydration and fluid balance, showing that the problem of fluid volume deficit has been corrected. Although a normal bowel movement, ability to tolerate intravenous fluids, and an increasing time interval between bowel movements are all positive signs, they do not specifically address the problem of deficient fluid volume.

Thursday 26 April 2018

Nurse Expert Advice, Nursing Skills, Nursing Guides

Nick Angelis doesn’t get much flak from doctors or other nurses because he has built himself to be eccentric and people never know what will come out of his mouth. 

“I work with an improvisation group, and I do a lot of writing and acting. People bully those who they think will cower. If they aren’t sure how it will go over with certain people, doctors will pick out the weakest,” he says.

Angelis, C.R.N.A. and M.S.N., is the author of How to Succeed in Anesthesia School (and RN, PA or Med School) and co-owner of the Florida-based BEHAVE Wellness, which trains individuals and corporations about bully prevention.  

What is considered inappropriate behavior?

As a nurse, he has seen his fair share of bad doctors who bully, throw things, get in people’s faces, and make workplaces miserable for others and a whole bunch of other bad behavior. 

Understanding what is considered inappropriate behavior could be the first defense against a difficult doctor. According to Jacksonville, Fla., University, disruptive behavior from a physician can encompass abusive, demeaning or profane language; rage or violent behavior such as throwing objects and physical abuse; insulting or disrespectful comments to or about staff, patients or families; inappropriate sexual comments or touching; repeated failure to respond to calls; and failure to take recommended corrective action.

What should you do if you feel unsafe? If you do feel unsafe with a doctor, Angelis says that most hospitals and workplaces these days have policies in place for these situations. 

“If you go to your boss or the human resource department and say, ‘I don’t feel safe right now,’ or ‘this is a toxic environment,’ most the time every management will pounce on it right away,” he says. 

When should you report inappropriate behavior?

Nurses are masters of hiding their true feelings, Angelis adds. But when something doesn’t feel right, and you have to start walking on eggshells at every move around a doctor, it’s time to say something. Also, you need to get to know certain doctors to understand if they are just being a jerk temporarily and let it roll off your back, he says.  

If the situation allows you to talk with that doctor before turning them in, then do it. Stand up for yourself and explain what that person did to you. If things don’t change, then go talk to a superior. 

Here are some tips to help your situation with a bad behaving doctor:


The end goal is to have a better workplace for yourself, Angelis says.

“No one can work endlessly at a job always going with righteousness and truth. Sometimes, you just need to get along opposed to having right on your side all the time.” 

The Type A personalities will confront bullying, and the others will hope it goes away, Angelis adds.


When people around you and in the administration don’t care that the doctors are bullies, then it’s time to find another job. Sometimes, that’s easier than making a fuss. Being honest in an exit interview can be the tough part, especially if you are in a highly specialized nursing area. You don’t want to burn any bridges, he adds.


Angelis uses flippancy, apathy or goofiness, and it has worked for him. Several times, he has said to a ranting, raving doctor that “This isn’t as a big of deal as you think it is.” That is a more direct confrontational way. If you take that approach, it’s not giving the doctors the benefit of worrying about something. You are basically saying to the doctor that they are overreacting, he said.


Hear what it’s like at prospective employers and how not to be an easy, lonely bullying target, Angelis says. Compare the rumors and opinions of several people to get closer to the truth. 


“I have a great sense of humor and an absent sense of drama,” he explains. “I find fun in situations that others would find dreary or stressful, and I don’t get offended easily.” 

This combination allows him to work long hours in difficult situations long after his peers are burned out or discouraged. Someone not as random or carefree needs to mentally prepare for an always shifting work environment. This way, you’re not making drama over petty, possibly misinterpreted behavior from physicians. 


When Angelis has had a doctor get misbehaving, he would look really seriously at them and say things like, “Cheetahs can only charge at 65 mph for about a quarter mile, but the key is in the flexibility of their spine.” They get unsettled trying to find the passive or aggressive meaning behind his nonsensical statement and then leaves him alone. 


Doctors have bad days, too, and sometimes, those stresses make them say and do things against those around them – just like everyone else. Angelis says that even nice people who get unhinged at work are finding their self-worth from that. It’s much harder to force good behavior from someone whose very identity is tied to their clinical performance, he says.

Angelis has found through the years and through bullying research that no one needs to feel like they have to be the crusader if they take some other job. 

“The Type A personalities will confront bullying. The others will hope it goes away,” he says.
Q. When assessing an elderly client, the nurse expects to find various aging-related physiologic changes. These changes include:

A. increased coronary artery blood flow.
B. decreased posterior thoracic curve.
C. decreased peripheral resistance.
D. delayed gastric emptying.

Correct Answer: D

Explanation: Aging-related physiologic changes include delayed gastric emptying, decreased coronary artery blood flow, an increased posterior thoracic curve, and increased peripheral resistance.

Wednesday 25 April 2018

Question Of The Day, Medication and I.V. Administration
Q. A client is scheduled for an excretory urography at 10 a.m. An order directs the nurse to insert a saline lock I.V. device at 9:30 a.m.. The client requests a local anesthetic for the I.V. procedure and the physician orders lidocaine-prilocaine cream (EMLA cream). The nurse should apply the cream at:

A. 7:30 a.m.
B. 8:30 a.m.
C. 9 a.m.
D. 9:30 a.m.

Correct Answer: A

Explanation: It takes up to 2 hours for lidocaine-prilocaine cream (EMLA cream) to anesthetize an insertion site. Therefore, if the insertion is scheduled for 9:30 a.m., EMLA cream should be applied at 7:30 a.m. The local anesthetic wouldn't be effective if the nurse administered it at the later times.

Tuesday 24 April 2018

Question Of The Day, Basic Psychosocial Needs
Q. A worried mother confides in the nurse that she wants to change physicians because her infant is not getting better. The best response by the nurse is which of the following?

A. "This doctor has been on our staff for 20 years."
B. "I know you are worried, but the doctor has an excellent reputation."
C. "You always have an option to change. Tell me about your concerns."
D. "I take my own children to this doctor."

Correct Answer: C

Explanation: Asking the mother to talk about her concerns acknowledges the mother's rights and encourages open discussion. The other responses negate the parent's concerns.

Saturday 21 April 2018

Question Of The Day, The Nursing Process
Q. When developing a care plan for a client with a do-not-resuscitate (DNR) order, a nurse should:

A. withhold food and fluids.
B. discontinue pain medications.
C. ensure access to spiritual care providers upon the client's request.
D. always make the DNR client the last in prioritization of clients.

Correct Answer: C

Explanation: Ensuring access to spiritual care, if requested by the client, is an appropriate nursing action. A nurse should continue to administer appropriate doses of pain medication as needed to promote the client's comfort. A health care provider may not withhold food and fluids unless the client has a living will that specifies this action. A DNR order does not mean that the client does not require nursing care.

Friday 20 April 2018

Question Of The Day, Gastrointestinal Disorders
Q. Which of the following laboratory findings are expected when a client has diverticulitis?

A. Elevated red blood cell count.
B. Decreased platelet count.
C. Elevated white blood cell count.
D. Elevated serum blood urea nitrogen concentration.

Correct Answer: C

Explanation: Because of the inflammatory nature of diverticulitis, the nurse would anticipate an elevated white blood cell count. The remaining laboratory findings are not associated with diverticulitis. Elevated red blood cell counts occur in clients with polycythemia vera or fluid volume deficit. Decreased platelet counts can occur as a result of aplastic anemias or malignant blood disorders, as an adverse effect of some drugs, and as a result of some heritable conditions. Elevated serum blood urea nitrogen concentration is usually associated with renal conditions.

Thursday 19 April 2018

My husband and I are both travel nurses and we started our journey in San Francisco. We got a taste for the real estate there when we found a studio apartment in the city for…wait for it…$2,600 a month. Yup, all 400 square feet of it. It was furnished, allowed dogs, and was leased to us for 3 months.

Travel Nursing, Nursing Skill, Nursing Pros and Cons

After a few weeks into our assignment, we became inspired to buy a Volkswagen Westfalia Vanagon, one of those nostalgic buses that look super cute on Instagram (#vanlife.) We bought a big orange one and used it as a means to see the country. We’ve used it to take multi-week road trips, as a temporary apartment when on assignment, and as a daily commuter.

This little van gave us a taste of setting up a portable living situation when going travel nursing and while living in this 60 square foot space was definitely challenging, there are many travel nurses that are doing it right! If you are considering taking your RV, camper, or any other home on wheels to your next travel assignment, add the following pros and cons to your research!

The PROs

It’s all about the money, honey.

Cost of renting an apartment can be steeply more expensive especially when renting apartments in highly populated areas. From deposits to pet fees to up-charges for short-term rentals, these costs all add up and don’t “go anywhere” in comparison to spending the same money investing in an RV or RV-like home. If you’re able to get your hands on a deal for a mobile living space - your savings have begun. Oh and that housing stipend? Straight to the bank, baby. 

The space is always yours.

No matter what happens, you always have a furnished space that feels like home. You know exactly where everything is. You know the intricacies and the idiosyncrasies of your space. And for all my healthcare germaphobes out there – you at least know that it’s only your cooties you’re dealing with, and not any previous unknowns.

Paws and portable snuggles. 

We have always traveled with our two dogs, and from experience, transitions are the hardest on them. The quicker we get into a routine, the better for their digestive systems – and our sanity. When we’ve moved around in our VW van, however, our home stays familiar to them and they go through a more minimal period of acclimation. The tricky part is keeping the space cool, especially during times when we leave for the day or night.

You get to change your mind as easy as one, two, free. 

There are a lot more RV parks than you’d think! If you claim your stake somewhere and decide you’re not vibing with it after a few weeks, you have all the freedom to pick up and head out to the next park that has a cafĂ© and a swimming pool. (Seriously, don’t underestimate RV parks. There are some pretty sweet ones out there.)

Greater connection with the outdoors. 

This comes naturally when living in a mobile space. It’s easy to get good sunlight and campsites typically have picnic tables and other outdoor amenities that draw people to enjoy the outer space. In contrast, it’s easy to get cooped up in an apartment, and there are way too many first-floor units out there that don’t get enough sunlight…even in the sunniest of cities.


You don’t get to move into a space that’s unique to that city.

Sometimes, I want to get a feel for the city, which to me means living in a space unique to that area, carving my place in the local community of permanent residents and transients alike. It makes me feel like I am truly “living” in the city, not just passing by.

You carry everything with you, like a turtle and its shell. 

There’s something kind of freeing about only packing your clothes, laptop, and yoga mat when you move somewhere for three months. Walking into furnished apartments and setting up life doesn’t take but maybe half a day, and when the assignment is all done, packing up and peacing-out is a breeze. Maybe you even board a plane and hit up your next destination without a second thought.

What’s your bathroom situation?

You could have one of those sweet RVs that have a shower and toilet (and maybe even a tub). Or the camping site may have community showers and bathrooms. But if you’ve parked your VW Westy in the hospital parking lot like we did for a bit, you better get creative about how to stay hygienic and how to manage your waste. We have spent many weeks showering after work in the cath lab employee bathrooms, using a bucket and kitty litter when the going was inevitable, and stocking up on enough scrubs to make it through a couple weeks without needing to visit a laundry mat. Ideal? Not really. Adventurous? Arguable. 

Any breakdowns and it’s your issue. 

This is true of any renter vs owner situation. If you’re renting and the pipes freeze, your landlord better be high-tailing it over. But if you didn’t take proper precautions of your camper and find out the hard way about cold weather, now you’re shouldering that cost and labor, and it may not be pretty. Not to mention breakdowns that could happen in-transit; if you’re on deadline to make it to your first day, you may find yourself ditching your kombi - with half of your things in it - at a storage facility en route to your next assignment, coming back to save it later (been there, done that).

Storing the thing.

What do you do with this home on wheels when you’re done with it? If you’ve got a place to park it in between assignments, you’re set. But sometimes parents’ homes are already overcrowded with cars and a 5th wheel doesn’t do much to help. Also, if you take an extended break from using it, you must stay mindful of sun-damage, mold, and other unfortunate things that could happen when a space goes unoccupied for long.

The Bottom Line

When you decide to go travel nursing, you must ultimately do what makes you happiest; this will get you through the toughest time of either option - and there will be tough times. Whether it’s fixing the AC on your home at a truck stop in 100-degree weather, or when you’re on your hands and knees scrubbing your apartment floor (after spending all day moving out) in order to avoid the $300 fee your complex will charge you if you’re unit is not “move-in ready.” Make the decision that best speaks to your soul (and your wallet) and those rough times will all be worth it!
Q. The nurse is caring for a client with asthma. The nurse should conduct a focused assessment to detect which of the following?

A. Increased forced expiratory volume.
B. Normal breath sounds.
C. Inspiratory and expiratory wheezing.
D. Morning headaches.

Correct Answer: C

Explanation: The hallmark signs of asthma are chest tightness, audible wheezing, and coughing. Inspiratory and expiratory wheezing is the result of bronchoconstriction. Even between exacerbations, there may be some soft wheezing, so a finding of normal breath sounds would be expected in the absence of asthma. The expected finding is decreased forced expiratory volume [forced expiratory flow (FEF) is the flow (or speed) of air coming out of the lung during the middle portion of a forced expiration] due to bronchial constriction. Morning headaches are found with more advanced cases of COPD and signal nocturnal hypercapnia or hypoxemia.

Wednesday 18 April 2018

Question Of The Day, Gastrointestinal Disorders
Q. A home health nurse who sees a client with diverticulitis is evaluating teaching about dietary modifications necessary to prevent future episodes. Which statement by the client indicates effective teaching?

A. "I'll increase my intake of protein during exacerbations."
B. "I should increase my intake of fresh fruits and vegetables during remissions."
C. "I'll snack on nuts, olives, and popcorn during flare-ups."
D. "I'll incorporate foods rich in omega-3 fatty acids into my diet."

Correct Answer: B

Explanation: A client with diverticulitis needs to modify fiber intake to effectively manage the disease. During episodes of diverticulitis, he should follow a low-fiber diet to help minimize bulk in the stools. A client with diverticulosis should follow a high-fiber diet. Clients with diverticular disease don't need to modify their intake of protein and omega-3 fatty acids.

Tuesday 17 April 2018

Q. The nurse is serving on the hospital ethics committee which is considering the ethics of a proposal for the nursing staff to search the room of a client diagnosed with substance abuse while he is off the unit and without his knowledge. Which of the following should be considered concerning the relationship of ethical and legal standards of behavior?

A. Ethical standards are generally higher than those required by law.
B. Ethical standards are equal to those required by law.
C. Ethical standards bear no relationship to legal standards for behavior.
D. Ethical standards are irrelevant when the health of a client is at risk.

Correct Answer: A

Explanation: Some behavior that is legally allowed might not be considered ethically appropriate. Legal and ethical standards are often linked, such as in the commandment "Thou shalt not kill." Ethical standards are never irrelevant, though a client's safety or the safety of others may pose an ethical dilemma for health care personnel. Searching a client's room when they are not there is a violation of their privacy. Room searches can be done with a primary health care provider's order and generally are done with the client present.

Monday 16 April 2018

Q. Which of the following interventions would be most appropriate for the nurse to recommend to a client to decrease discomfort from hemorrhoids?

A. Decrease fiber in the diet.
B. Take laxatives to promote bowel movements.
C. Use warm sitz baths.
D. Decrease physical activity.

Correct Answer: C

Explanation: Use of warm sitz baths can help relieve the rectal discomfort of hemorrhoids. Fiber in the diet should be increased to promote regular bowel movements. Laxatives are irritating and should be avoided. Decreasing physical activity will not decrease discomfort.

Saturday 14 April 2018

Nursing Skills, Nursing Tutorials and Materials, Nursing, Nurse Healthcare

Active shooter incidents are increasing at an alarming rate, and although they occur mostly in public places, at businesses, and in schools, they can happen anywhere, at any time – including in a healthcare facility. These incidents strike suddenly, without warning, and people are usually stunned into inaction. Being mentally prepared will help you to take action immediately on the “Run, Hide, Fight” continuum and could save your own and other’s lives.

An active shooter incident is defined as a situation in which the attacker is “actively engaged in killing or attempting to kill people in a confined and populated area.” The gunman does not come to the area with the intent to commit any other crime. Most often the incident is over within 10-15 minutes, even before law enforcement arrives. This emphasizes why it is essential for ordinary people to know how to react.

Chaos and panic usually characterize the scene – there is noise from gunshots and alarms, people are running and screaming. Even those who are trained initially experience the typical human reaction to fear and anxiety, often combined with disbelief and denial. Many of those who have suffered active shooter incidents say afterward that they didn’t know what to do or that they were just waiting to take the next bullet. Knowing how to react provides the mental preparation needed to gain self-control, recall some of what was learned and proceed to action. A single individual taking the lead can contribute significantly to their own as well as others’ chances of survival.

Run, hide, fight

The essence of action in an active shooter situation is to respond immediately with run, hide or fight – in that order. No one situation is the same and the specific circumstances, including on how close you are to the shooter, will determine the choice of action. One might not make the best decision, but any action is better than doing nothing.

Nursing Skills, Nursing Tutorials and Materials, Nursing, Nurse Healthcare

The idea is to run away from the shooter wherever possible and to encourage others to do the same. Assess exits and have an escape plan in mind. Encourage or help others to escape – a forceful call of “Follow me” or “Gunshot! Get away!” can be used to pull bystanders out of their inertia. However, don’t get caught up by anyone who chooses not to follow and don’t try and move persons who are already wounded. Leave personal belongings behind and keep your hands visible while moving. You can call 911 once you are in a safe space.

If you are unable to evacuate the area the next option is to try and hide away where you will be out of the shooter’s view. Ideally, look for a space where you will be protected if shots are fired in your direction, for example behind a door or a piece of furniture. Wherever possible get into a room and lock the door, which can also be barricaded with heavy furniture. Remain quiet and avoid any noise by putting phones on silent and turning off any radio or television. You can dial 911 if it is safe, even just leaving the line open if you cannot speak. This will assist law enforcement in locating the shooter.

The last resort, if your life is in immediate danger, is to fight. Try to disrupt or incapacitate the shooter by acting as aggressively as possible towards him – yell, throw heavy items at him or even try and take him out with makeshift weapons. While this advice appears counterintuitive, your chances of survival if you can’t escape are much greater if the shooter can be distracted or taken down.

Co-operate with law enforcement officers once they arrive. Their priority is to stop the shooter as soon as possible. They could appear aggressive – they are armed, may use pepper spray or tear gas, shout commands and push people around. Follow the officers’ instructions and answer their questions promptly. The information they need is the location of the shooter/s, how many there are, and the type of weapons if known. Don’t try and get information from them, expect them to guide you or to attend to the wounded. Put down anything you may be holding in your hands, even bags or jackets, raise your hands and keep them visible.

Give help once it is safe

Injured people can be attended to once it is safe. As a nurse, you could provide life-saving assistance, such as quick hemorrhage control, while waiting for emergency medical staff to arrive. Bear in mind that once the shooter is incapacitated or arrested the location is a crime scene and nothing should be moved or touched except in relation to helping the injured. After initial treatment, casualties are usually moved to a central assembly point where a mass casualty plan will be implemented. Here you can also help in line with your knowledge, training, and skills.

Every healthcare facility is required to have an emergency action plan, and most of them conduct training exercises to prepare staff for emergency situations. These exercises are often limited to evacuation drills in the case of fire or bomb threats. The current reality, however, also calls for activities to prepare staff on what to expect and how to react in an active shooter situation. Arrangements can also be made with one of the various agencies to provide staff with active shooter preparedness training.
Question Of The Day, The Nursing Process
Q. During the health history interview, which of the following strategies is the most effective for the nurse to use to help clients take an active role in their health care?

A. Ask clients to complete a questionnaire.
B. Provide clients with written instructions.
C. Ask clients for their description of events and for their views concerning past medical care.
D. Ask clients if they have any questions.

Correct Answer: C

Explanation: One of the best strategies to help clients feel in control is to ask them their view of situations, and to respond to what they say. This technique acknowledges that clients' opinions have value and relevance to the interview. It also promotes an active role for clients in the process. Use of a questionnaire or written instructions is a means of obtaining information but promotes a passive client role. Asking whether clients have questions encourages participation, but alone it does not acknowledge their views.

Friday 13 April 2018

Q. Which of the following client statements indicates that the client with hepatitis B understands discharge teaching?

A. "I will not drink alcohol for at least 1 year."
B. "I must avoid sexual intercourse."
C. "I should be able to resume normal activity in a week or two.
D. "Because hepatitis B is a chronic disease, I know I will always be jaundiced."

Correct Answer: A

Explanation: It is important that the client understand that alcohol should be avoided for at least 1 year after an episode of hepatitis. Sexual intercourse does not need to be avoided, but the client should be instructed to use condoms until the hepatitis B surface antigen measurement is negative. The client will need to restrict activity until liver function test results are normal; this will not occur within 1 to 2 weeks. Jaundice will subside as the client recovers; it is not a permanent condition.

Thursday 12 April 2018

Question Of The Day, Antepartum Period
Q. A client in the triage area who is at 19 weeks' gestation states that she has not felt her baby move in the past week and no fetal heart tones are found. While evaluating this client, the nurse identifies her as being at the highest risk for developing which problem?

A. Abruptio placentae.
B. Placenta previa.
C. Disseminated intravascular coagulation.
D. Threatened abortion.

Correct Answer: C

Explanation: A fetus that has died and is retained in utero places the mother at risk for disseminated intravascular coagulation (DIC) because the clotting factors within the maternal system are consumed when the nonviable fetus is retained. The longer the fetus is retained in utero, the greater the risk of DIC. This client has no risk factors, history, or signs and symptoms that put her at risk for either abruptio placentae or placenta previa, such as sharp pain and "woody," firm consistency of the abdomen (abruption) or painless bright red vaginal bleeding (previa). There is no evidence that she is threatening to abort as she has no complaints of cramping or vaginal bleeding.

Wednesday 11 April 2018

Question Of The Day, The Nursing Process
Q. A parent brings a 5-year-old child to a vaccination clinic to prepare for school entry. The nurse notes that the child has not had any vaccinations since 4 months of age. To determine the current evidence for best practices for scheduling missed vaccinations the nurse should:

A. Ask the primary care provider.
B. Check the website at the Center for Disease Control and Prevention (CDC).
C. Read the vaccine manufacturer's insert.
D. Contact the pharmacist.

Correct Answer: B

Explanation: The CDC is the federal body that is ultimately responsible for vaccination recommendations for adults and children. A division of the CDC, the Advisory Committee on Immunization Practices, reviews vaccination evidence and updates recommendation on a yearly basis. The CDC publishes current vaccination catch-up schedules that are readily available on their website. The lack of vaccinations is a strong indicator that the child probably does not have a primary care provider. If consulted, the pharmacist would most likely have to review the CDC guidelines that are equally available to the nurse. Reading the manufacturer's inserts for multiple vaccines would be time consuming and synthesis of the information could possibly lead to errors.

Tuesday 10 April 2018

Q. Which of the following statements would provide the best guide for activity during the rehabilitation period for a client who has been treated for retinal detachment?

A. Activity is resumed gradually, and the client can resume her usual activities in 5 to 6 weeks.
B. Activity level is determined by the client's tolerance; she can be as active as she wishes.
C. Activity level will be restricted for several months, so she should plan on being sedentary.
D. Activity level can return to normal and may include regular aerobic exercises.

Correct Answer: A

Explanation: The scarring of the retinal tear needs time to heal completely. Therefore, resumption of activity should be gradual; the client may resume her usual activities in 5 to 6 weeks. Successful healing should allow the client to return to her previous level of functioning.

Monday 9 April 2018

Question Of The Day, Gastrointestinal Disorders
Q. A nurse preceptor is working with a student nurse who is administering medications. Which statement by the student indicates an understanding of the action of an antacid?

A. "The action occurs in the stomach by increasing the pH of the stomach contents and decreasing pepsin activity."
B. "The action occurs in the small intestine, where the drug coats the lining and prevents further ulceration."
C. "The action occurs in the esophagus by increasing peristalsis and improving movement of food into the stomach."
D. "The action occurs in the large intestine by increasing electrolyte absorption into the system that decreases pepsin absorption."

Correct Answer: A

Explanation: The action of an antacid occurs in the stomach. The anions of an antacid combine with the acidic hydrogen cations secreted by the stomach to form water, thereby increasing the pH of the stomach contents. Increasing the pH and decreasing the pepsin activity provide symptomatic relief from peptic ulcer disease. Antacids don't work in the large or small intestine or in the esophagus.

Friday 6 April 2018

Most nurses cringe at the idea of working night shifts. However, while the majority of us have a long list of bad ideas about working at night, some nurses actually prefer the working schedule.

If you’ve ever wondered why they like night shifts, then this list will surely give you a much clearer idea.

1. Higher pay

Working on night shifts can increase your pay by as much as 10%, depending on your state’s law. It can even go up if you’re working on night shifts on a weekend

“I used to hate going on night shifts. But considering night differentials, I thought the same 8 hours I work during the day can earn me more if I clock in at night,” a ward nurse share

2. More relaxed patient routine

Morning shifts come with a lot of interruptions, from meetings to doctors doing their rounds. There’s also more visitors checking in on their patients during the day. Although these things sound relatively reasonable for nurses, we must have to admit that they can cause us a lot of stress.

Nurses Skill, NCLEX Exam, Nursing Tips and Tutorials
Night shifts aren’t only relaxing for the patients but for nurses as well.

Night shifts are slower in pace. Since patients are set to rest and sleep, most of them only need monitoring. Aside from the benefit of a more relaxed environment, working at night also gives us more opportunity to connect with our patients, such as addressing concerns or giving them a soothing back rub.

3. Fewer people on the floor.

If you get annoyed by visitors persistently asking you questions, then night shifts are definitely for you. During the night, there are fewer people visiting patients which mean there’s also fewer people persistently asking you questions!

“Night shifts work best for me because I have very limited tolerance for visitors whom I have no clear idea what they’re asking or which patient they are referring to. Nurses can only get so busy, and the last thing we want is to have to discuss our patient’s anatomy and physiology to his clueless relatives,” an ICU nurse said.

4. Better family time.

Nurses Skill, NCLEX Exam, Nursing Tips and Tutorials
While night shifts can mean lesser sleeping hours, most parents wouldn’t trade these precious moments for anything.

Working at night enables nurses who are parents to catch up with their children and family. You’ll be able to prepare your kids’ meals for school, help them with their home works and tidy up your home. You can even attend to their school activities or take them for a short trip to the park.

5. Improved working relationship

Working at night enable nurses to foster a closer friendship since the environment is less tense and hectic. They can share stories and even their tips and tricks on surviving night shifts and transition from day to night shift.

“My co-workers and I have a favorite place where we eat after our shift. If we’re not eating there, we spend breakfast at each other’s house. We always have a good laugh. It’s really a good way to de-stress,” an ER nurse shared.
Q. A nurse is developing a nursing diagnosis for a client. Which information should she include?

A. Actions to achieve goals
B. Expected outcomes
C. Factors influencing the client's problem
D. Nursing history

Correct Answer: C

Explanation: A nursing diagnosis is a written statement describing a client's actual or potential health problem. It includes a specified diagnostic label, factors that influence the client's problem, and any signs or symptoms that help define the diagnostic label. Actions to achieve goals are nursing interventions. Expected outcomes are measurable behavioral goals that the nurse develops during the evaluation step of the nursing process. The nurse obtains a nursing history during the assessment step of the nursing process.

Thursday 5 April 2018

Q. A nurse assesses a client's respiratory status. Which observation indicates that the client is having difficulty breathing?

A. Diaphragmatic breathing
B. Use of accessory muscles
C. Pursed-lip breathing
D. Controlled breathing

Correct Answer: B

Explanation: The use of accessory muscles for respiration indicates the client is having difficulty breathing. Diaphragmatic and pursed-lip breathing are two controlled breathing techniques that help the client conserve energy.

Wednesday 4 April 2018

Question Of The Day, Neurosensory Disorders
Q. When planning care for a client with a head injury, which position should the nurse include in the care plan to enhance client outcomes?

A. Trendelenburg's
B. 30-degree head elevation
C. Flat
D. Side-lying

Correct Answer: B

Explanation: For clients with increased intracranial pressure (ICP), the head of the bed should be elevated to 30 degrees to promote venous outflow. Trendelenburg's position is contraindicated because it can raise ICP. Flat or neutral positioning is indicated when elevating the head of the bed would increase the risk of neck injury or airway obstruction. A side-lying position isn't specifically a therapeutic treatment for increased ICP.

Tuesday 3 April 2018

Question Of The Day, Gastrointestinal Disorders
Q. Before an incisional cholecystectomy is performed, the nurse instructs the client in the correct use of an incentive spirometer. Why is incentive spirometry essential after surgery in the upper abdominal area?

A. The client will be maintained on bed rest for several days.
B. Ambulation is restricted by the presence of drainage tubes.
C. The operative incision is near the diaphragm.
D. The presence of a nasogastric tube inhibits deep breathing.

Correct Answer: C

Explanation: The incisions made for upper abdominal surgeries, such as cholecystectomies, are near the diaphragm and make deep breathing painful. Incentive spirometry, which encourages deep breathing, is essential to prevent atelectasis after surgery. The client is not maintained on bed rest for several days. The client is encouraged to ambulate by the first postoperative day, even with drainage tubes in place. Nasogastric tubes do not inhibit deep breathing and coughing.

Monday 2 April 2018

Question Of The Day, Antepartum Period
Q. A 16-year-old primigravida at 36 weeks' gestation who has had no prenatal care experienced a seizure at work and is being transported to the hospital by ambulance. Which of the following should the nurse do upon the client's arrival?

A. Position the client in a supine position.
B. Auscultate breath sounds every 4 hours.
C. Monitor the vital signs every 4 hours.
D. Admit the client to a quiet, darkened room.

Correct Answer: D

Explanation: Because of her age and report of a seizure, the client is probably experiencing eclampsia, a condition in which convulsions occur in the absence of any underlying cause. Although the actual cause is unknown, adolescents and women older than 35 years are at higher risk. The client's environment should be kept as free of stimuli as possible. Thus, the nurse should admit the client to a quiet, darkened room. Clients experiencing eclampsia should be kept on the left side to promote placental perfusion. In some cases, edema of the lungs develops after seizures and is a sign of cardiovascular failure. Because the client is at risk for pulmonary edema, breath sounds should be monitored every 2 hours. Vital signs should be monitored frequently, at least every hour.



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