Question Of The Day: Neurosensory Disorders

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

Reason: 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.

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5 Best Ways to Level-Up Your Nursing Career

Today, nursing is at a pivotal moment where the opportunities to develop a career and innovate to improve care for patients have never been greater.

There have never been so many diverse opportunities for nursing in today’s healthcare sector. As technology advances and life expectancy has increased, innovative ways of working are beginning to rapidly shape the nursing career pathway.

But how can you find out more about these new alternatives, and how can you prepare to step into these roles to further your nursing career? These 5 opportunities will give you the creative motivation you need to move into your next nursing role.

Specialize in Areas of High Demand

The world of nursing has changed dramatically in the last generation and from many nurses’ training days. Today, hospital beds are filled with more older people with complex conditions, multiple long-term illnesses, and frailty issues. People who would have spent several days recovering in a hospital are now looked after at home, and technology is transforming the way that clinics are operated. What was once a major surgical procedure is now done by interventional radiology. All these changes mean that nursing has had to adapt and transform to meet the new and increasing demand.

If you plan on furthering your career in nursing, check out the areas where demand is and will be increasing in the next few years. Wound care, for example, is an area of high demand but that has a shortage of skilled practitioners. Along similar lines, good discharge planning is critical with increased scrutiny from the Centers for Medicare & Medicaid Services (CMS). Might you be that expert planner?

As for technological advances, artificial intelligence already has impacted many areas of healthcare, but are you aware of how it could transform the way you work? As surgical techniques advance, there is a need to train nurses in new ways of working in the clinical teams. All these opportunities indicate a need to start specializing where there is high demand.

Further Your Education

There is always something new to learn, however long you have been in the nursing profession. Discover which skills you need to take the next step in your career and start looking at how you can learn about a new specialty or way of working.

Brian Cook, a registered nurse working in Chicago, outlines his reasons for furthering his education:

“One of the reasons I chose to get my Master’s degree upon deciding to become a nurse for my second career was that I had spoken with a nurse who had also started it as a second career, but had only gotten his Bachelor’s degree; he advised me to get a master’s from the start. He had found that there were openings in management roles at his hospital that he knew he would be capable of performing, but that he couldn’t even apply for them without the capital MSN behind his name. His fundamental point: the more education you have, the higher you’ll be able to advance; but also that once you start working, the barriers to continuing your education become very real.”

That said, you do not need to get your master’s degree to improve your career possibilities. There are ample courses and programs available including higher degrees. The internet has transformed learning by offering online opportunities. These courses usually have a flexible learning approach, which is ideal if you are working and studying at the same time.

Don’t forget to look at the taster courses that are available online free. These give an insight into diverse skills and education opportunities, enabling you to get a feel for an aspect of learning without making a large investment in training. When you are looking at educational courses, do check out their credibility and that what they are offering is recognized by employers. This saves a lot of heartache by inadvertently taking a substandard course.

Subspecialize

As a nurse, there are so many opportunities to follow on a career journey. It is worth having a subspecialty within your portfolio as it builds specialist expertise. This enables you to apply for and get niche roles and a higher salary where skills are in demand. Pediatrics, mental health, renal, critical care, and oncology nursing are just some of the subspecialist areas where demand outstrips the availability of qualified staff and where there are opportunities to grow your career. This not only furthers your career as a clinical nurse but enables you to have that expertise to manage specialist and niche departments or to work in a community setting using your specialism. It may also be a stepping stone to clinical education or research.

Get A Mentor

Advancing your nursing career goes further than courses or degrees. You’ll need to learn the softer skills associated with leadership, developing others, and dealing with challenging situations effectively. One of the best ways to do this is to find a mentor who can guide you through leadership scenarios, enabling you to grow and develop your skills.

Keeping a portfolio with a reflective diary also helps with learning from practice. Some interviews use scenarios to test for the experience of situations such as implementing a change in a department so having these records helps with job application preparation. And when you achieve that goal of being in a senior position, you can repay the love by mentoring a nurse hoping to further their career.

Look for the Next Trend

There are countless opportunities for nurses to innovate and develop their careers. This involves looking for the next big trend and being ready to step up. Examples include global shortages of specialist doctors and exploring where nurse practitioners can take on work once done by them, and especially where there are gaps in services.

Again, technology is another opportunity where nurses can provide salient and practical advice or educate others. With the introduction of methods in artificial intelligence, there will be opportunities to predict disease and support those people at risk to stay healthy. All these roles are opportunities for nurses to grow, develop, and further their careers.

Source: nurseslabs.com

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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

Reason: 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.

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Question Of The Day: Antepartum Period

Q. A nurse is providing care for a pregnant client in her second trimester. Glucose tolerance test results show a blood glucose level of 160 mg/dl. The nurse should anticipate that the client will need to:

A. start using insulin.
B. start taking an oral antidiabetic drug.
C. monitor her urine for glucose.
D. be taught about diet.

Correct Answer: D

Reason: The client will need to watch her overall diet intake to control her blood glucose level. The client's blood glucose level should be controlled initially by diet and exercise, rather than insulin. Oral antidiabetic drugs aren't used in pregnant clients. Urine glucose levels aren't an accurate indication of blood glucose levels.

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Question Of The Day: Mood, Adjustment, and Dementia Disorders

Q. The nurse meets with the client and his wife to discuss depression and the client's medication. Which of the following comments by the wife would indicate that the nurse's teaching about disease process and medications has been effective?

A. "His depression is almost cured."
B. "He's intelligent and won't need to depend on a pill much longer."
C. "It's important for him to take his medication so that the depression will not return or get worse."
D. "It's important to watch for physical dependency on Zoloft."

Correct Answer: C

Reason: Improved balance of neurotransmitters is achieved with medication. Clients with endogenous depression must take antidepressants to prevent a return or worsening of depressive symptoms. Depression is a chronic disease characterized by periods of remission; however, it is not cured. Depression is not dependent on the client's intelligence to will the illness away. Zoloft is not physically addictive. 

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Question Of The Day: The Nursing Process

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

Reason: 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.

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Question Of The Day: Respiratory Disorders

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

Reason: 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.

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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

Reason: 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. 

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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

Reason: 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.

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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

Reason: 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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Question Of The Day: Mood, Adjustment, and Dementia Disorders

Q. A nurse is facilitating mandated group therapy for clients who have sexually abused children. Children who are victims of sexual abuse are typically:

A. from any segment of the population.
B. of low socioeconomic background.
C. strangers to the abuser.
D. willing to engage in sexual acts with adults.



Correct Answer: A

Reason: Victims of childhood sexual abuse come from all segments of the population and from all socioeconomic backgrounds. Most victims know their abuser. Children rarely willingly engage in sexual acts with adults because they don't have full decision-making capacities.

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Question Of The Day: The Nursing Process

Q. A nurse has received change-of-shift-report and is briefly reviewing the documentation about a client in the client's medical record. A recent entry reads, "Client was upset throughout the morning." How could the charting entry be best improved?

A. The entry should include clearer descriptions of the client's mood and behavior.
B. The entry should avoid mentioning cognitive or psychosocial issues.
C. The entry should list the specific reasons that the client was upset.
D. The entry should specify the subsequent interventions that were performed.

Correct Answer: A

Reason: Entries in the medical record should be precise, descriptive, and objective. An adjective such as "upset" is unclear and open to many interpretations. As such, the nurse should elaborate on this description so a reader has a clearer understanding of the client's state of mind. Stating the apparent reasons that the client was "upset" does not resolve the ambiguity of this descriptor. Cognitive and psychosocial issues are valid components of the medical record. Responses and interventions should normally follow assessment data but the data themselves must first be recorded accurately.

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Question Of The Day: Basic Physical Care

Q. A man of Chinese descent is admitted to the hospital with multiple injuries after a motor vehicle accident. His pain is not under control. The client states, "If I could be with my people, I could receive acupuncture for this pain." The nurse should understand that acupuncture in the Asian culture is based on the theory that it:

A. Purges evil spirits.
B. Promotes tranquility.
C. Restores the balance of energy.
D. Blocks nerve pathways to the brain.

Correct Answer: C

Reason: Acupuncture, like acumassage and acupressure, is performed in certain Asian cultures to restore the energy balance within the body. Pressure, massage, and fine needles are applied to energy pathways to help restore the body's balance. Acupuncture is not based on a belief in purging evil spirits. Although pain relief through acupuncture can promote tranquility, acupuncture is performed to restore energy balance. In the Western world, many researchers think that the gate-control theory of pain may explain the success of acupuncture, acumassage, and acupressure.

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Question Of The Day: Respiratory Disorders

Q. A nurse is caring for a client who has a tracheostomy and temperature of 103° F (39.4° C). Which intervention will most likely lower the client's arterial blood oxygen saturation?

A. Endotracheal suctioning
B. Encouragement of coughing
C. Use of a cooling blanket
D. Incentive spirometry



Correct Answer: A

Reason: Endotracheal suctioning removes secretions as well as gases from the airway and lowers the arterial oxygen saturation (SaO2) level. Coughing and using an incentive spirometer improve oxygenation and should raise or maintain oxygen saturation. Because of superficial vasoconstriction, using a cooling blanket can lower peripheral oxygen saturation readings, but SaO2 levels wouldn't be affected.

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Question Of The Day: Neurosensory Disorders

Q. A nurse is caring for a client diagnosed with a cerebral aneurysm who reports a severe headache. Which action should the nurse perform?

A. Sit with the client for a few minutes.
B. Administer an analgesic.
C. Inform the nurse manager.
D. Call the physician immediately.



Correct Answer: D

Reason: The nurse should notify the physician immediately because the headache may be an indication that the aneurysm is leaking. Sitting with the client is appropriate but only after the physician has been notified of the change in the client's condition. The physician will decide whether or not administration of an analgesic is indicated. Informing the nurse manager isn't necessary.

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ANA's President Calls Nurses "Warriors Without Armor"- Survey Finds 66% Lack Adequate PPE

As our nation battles an invisible, deadly enemy, we continue to send our frontline warriors into danger without sufficient armor.

Our military does not send troops into battle without the equipment they need to stay safe. And as a former volunteer firefighter, I would never have been required to respond to a fire without the proper gear.

Yet this is what we are asking of our nurses, other health care workers, and first responders when they lack the PPE–personal protective equipment–-they need. And this is occurring as the number of COVID-19 cases continues to grow unabated, and the number of N95 respirators and other emergency supplies available through the Strategic National Stockpile is running out. 

ANA’s Survey on Access To PPE

On March 20, the American Nurses Association began a survey of nurses nationwide about their access to PPE and other work environment concerns. According to findings from more than 20,000 respondents:

◉ 76% reported being extremely concerned about PPE,
◉ 66% reported being out or short of N95 respirators,
◉ 62% were out or short of full-face shields, and 61 percent were out or short of surgical masks.
◉ 69% reported concerns about working short-staffed.

Further, we hear disturbing reports that employers have retaliated against nurses and other health care workers for raising legitimate concerns about their personal safety and the safety of patients.  

Protecting Nurses Safeguards The Public

Protecting the safety and health of nurses and other frontline workers is directly related to safeguarding the public and stemming the spread and impact of the virus. 

Without the right PPE, nurses are concerned about unintentionally transmitting the virus to patients under their care, or to those in their communities.

According to our survey, 85% also worry about keeping their families safe from becoming infected.

There are countless stories from nurses and other health care workers who go to great lengths to prevent potentially contaminating their family members. For example, many have an elaborate system in place to shed their work clothes before stepping into their homes. They also describe isolating themselves as much as possible from their children and other family members – a state of affairs that’s causing great anguish to many.  At this point, we can’t even measure the toll the pandemic will take on the mental health of nurses in the long term. 

There are no definitive numbers on how many health care workers have been infected in the United States, although at least 15 nurses have died. According to an April 3 article in U.S. News and World Report,

◉ 4.4% of health care workers in Pennsylvania had COVID-19,
◉ 10.6% of Oklahoma’s coronavirus patients were identified as working in health care,
◉ Alarmingly, about 20% of cases in Ohio are among health care workers.

In cities such as New York and Boston, we hear about hundreds of health care workers who are COVID positive and in quarantine, depleting the already stretched ranks on the frontlines. 

Looking globally, the International Council of Nurses shared with BBC World News that the infection rate among health care workers in Italy was about 9 percent, and in Spain, reportedly 12 percent, further adding to the staffing crisis in hospitals. 

Nurses are waiting for more protective gear to arrive. 

President Trump signed legislation that allocates funds aimed at bolstering public health efforts and supplies. He has ordered one manufacturer, so far, to ramp up its production of N95 respirators. However, it will take time for that company to retool its shop and begin the production necessary to meet this challenge. 

Although it is encouraging to hear federal officials share details about the procurement and delivery of PPE and other medical equipment, we are still hearing that sufficient supplies of PPE are not getting to those who most desperately need them to take care of patients and themselves. The report from the U.S. Department of Health and Human Services' Office of Inspector General of survey findings from 323 hospitals reinforces what we are hearing about PPE, including the lack of a robust supply chain, problems with the amount and quality of supplies coming from the Strategic National Stockpile, as well as challenges related to changing guidance from the Centers for Disease Control and Prevention and conflicting guidance from federal, state and local authorities.

As we head into what is predicted to be the most difficult and deadly weeks yet in this country, our plea is urgent. Our courageous nurses are working around the clock under battlefield conditions to care for the sick and dying, putting their own health and safety at risk.  It is both a moral and strategic imperative for our nation’s leaders to do everything possible to arm and protect nurses and other critical responders. 

Source: nurse.org

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Question Of The Day: Gastrointestinal Disorders

Q. A client who has been diagnosed with gastroesophageal reflux disease (GERD) complains of heartburn. To decrease the heartburn, the nurse should instruct the client to eliminate which of the following items from the diet?

A. Lean beef.
B. Air-popped popcorn.
C. Hot chocolate.
D. Raw vegetables.

Correct Answer: C

Reason: With GERD, eating substances that decrease lower esophageal sphincter pressure causes heartburn. A decrease in the lower esophageal sphincter pressure allows gastric contents to reflux into the lower end of the esophagus. Foods that can cause a decrease in esophageal sphincter pressure include fatty foods, chocolate, caffeinated beverages, peppermint, and alcohol. A diet high in protein and low in fat is recommended for clients with GERD. Lean beef, popcorn, and raw vegetables would be acceptable.

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Question Of The Day: The Neonate

Q. A woman who has recently immigrated from Africa who delivered a term neonate a short time ago requests that a "special bracelet" be placed on the baby's wrist. The nurse should:

A. Tell the mother that the bracelet is not recommended for cleanliness reasons.
B. Apply the bracelet on the neonate's wrist as the mother requests.
C. Place the bracelet on the neonate, limiting its use to when the neonate is with the mother.
D. Recommend that the mother wait until she is discharged to apply the bracelet.

Correct Answer: B

Reason: The nurse should abide by the mother's request and place the bracelet on the neonate. In some cultures, amulets and other special objects are viewed as good luck symbols. By allowing the bracelet, the nurse demonstrates culturally sensitive care, promoting trust. The neonate can wear the bracelet while with the mother or in the nursery. The bracelet can be used while the neonate is being bathed, or if necessary and acceptable to the client removed and replaced afterward.

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Question Of The Day: School-age Child

Q. A 10-year-old child diagnosed with acute glomerulonephritis is admitted to the pediatric unit. The nurse should ensure that which action is a part of the child's care?

A. Taking vital signs every 4 hours and obtaining daily weight
B. Obtaining a blood sample for electrolyte analysis every morning
C. Checking every urine specimen for protein and specific gravity
D. Ensuring that the child has accurate intake and output and eats a high-protein diet

Correct Answer: A

Reason: Because major complications — such as hypertensive encephalopathy, acute renal failure, and cardiac decompensation — can occur, monitoring vital signs (including blood pressure) is an important measure for a child with acute glomerulonephritis. Obtaining daily weight and monitoring intake and output also provide evidence of the child's fluid balance status. Sodium and water restrictions may be ordered depending on the severity of the edema and the extent of impaired renal function. Typically, protein intake remains normal for the child's age and is only increased if the child is losing large amounts of protein in the urine. Checking urine specimens for protein and specific gravity and daily monitoring of serum electrolyte levels may be done, but their frequency is determined by the child's status. These actions are less important nursing measures in this situation.

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Question Of The Day: The Nursing Process

Q. A client has the following arterial blood gas values: pH, 7.30; PaO2, 89 mm Hg; PaCO2, 50 mm Hg; and HCO3–, 26 mEq/L. Based on these values, the nurse should suspect which condition?

A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis

Correct Answer: A

Reason: This client has a below-normal (acidic) blood pH value and an above-normal partial pressure of arterial carbon dioxide (PaCO2) value, indicating respiratory acidosis. In respiratory alkalosis, the pH value is above normal and the PaCO2 value is below normal. In metabolic acidosis, the pH and bicarbonate (HCO3–) values are below normal. In metabolic alkalosis, the pH and HCO3– values are above normal.

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Question Of The Day: Basic Physical Care

Q. The nurse walks into a client's room to administer the 9:00 a.m. medications and notices that the client is in an awkward position in bed. What is the nurse's first action?

A. Ask the client his name.
B. Check the client's name band.
C. Straighten the client's pillow behind his back.
D. Give the client his medications.



Correct Answer: C

Reason: The nurse should first help the client into a position of comfort even though the primary purpose for entering the room was to administer medication. After attending to the client's basic care needs, the nurse can proceed with the proper identification of the client, such as asking the client his name and checking his armband, so that the medication can be administered.

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Question Of The Day: Respiratory Disorders

Q. A client is prescribed metaproterenol (Alupent) via a metered-dose inhaler, two puffs every 4 hours. The nurse instructs the client to report adverse effects. Which of the following are potential adverse effects of metaproterenol?

A. Irregular heartbeat.
B. Constipation.
C. Pedal edema.
D. Decreased pulse rate.

Correct Answer: A

Reason: Irregular heartbeats should be reported promptly to the care provider. Metaproterenol (Alupent) may cause irregular heartbeat, tachycardia, or anginal pain because of its adrenergic effect on beta-adrenergic receptors in the heart. It is not recommended for use in clients with known cardiac disorders. Metaproterenol does not cause constipation, pedal edema, or bradycardia.

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Question Of The Day: Neurosensory Disorders

Q. A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should:

A. provide instructions on eye patching.
B. assess the client's visual acuity.
C. demonstrate eyedrop instillation.
D. teach about intraocular lens cleaning.



Correct Answer: C

Reason: Eyedrop instillation is a critical component of self-care for a client with glaucoma. After demonstrating eyedrop instillation to the client and family, the nurse should verify their ability to perform this measure properly. An eye patch isn't necessary unless the client has undergone surgery. Visual acuity assessment isn't necessary before discharge. Intraocular lenses aren't implanted in clients with glaucoma.

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These Are The 6 Hidden Costs Of Nursing School

Although nursing school is most certainly an investment in your future that will more than pay itself off, paying for your education as a nurse could present an initial challenge. 

The cost of nursing school can vary quite a bit on the type of school you choose—such as if you go to a private school vs. a community college—and the type of program you are looking to enroll in, such as an Associate or Bachelor’s degree.

Typically, a community college will provide the most affordable route to earning your nursing degree, followed by a state university, and lastly, a private one. However, that can really depend on what kind of financial aid and scholarships you have, so there is no way to predict exactly how much your degree will cost you. 

Overall, you can expect that the cost of a nursing degree can range anywhere from around $20,000 to upwards of $80,000. As just one example, the cost of an Associate Degree in Nursing (ADN) at a community college in Michigan is estimated to be just over $22,000 in tuition.

Beyond Your Tuition

Outside of the direct costs of your school’s tuition, you will also want to anticipate some of the “hidden” costs of nursing school. From the costs of scrubs to the income you might you lose, here’s a look at what you can expect to budget for during nursing school.  

1. UNIFORMS AND ACCESSORIES

You will be required to purchase your own uniform for your nursing school clinicals, as well as the accessories you need, such as your stethoscope, scissors, and penlight. Most school programs have a package you can purchase through them directly, but a standard-issue professional stethoscope—such as a Littmann—can run you about $90. 

A set of scrubs can be as cheap as $20, but if you have back-to-back clinical days, you might also consider purchasing an extra set or two—unless you really, really love laundry. (Also, for the record, I couldn’t afford more than one set of scrubs, so sometimes, you do what you have to do!) 

2. HEALTH COSTS

You will most likely accrue some health-associated costs as part of your nursing program. These may include a drug screening test, a background check, a TB test, bloodwork, and any required booster shots, and a Hepatitis B vaccine series. You may also be expected to purchase your own malpractice insurance as a healthcare professional. 

3. BOOKS 

I won’t lie to you—some nursing books can be really, really expensive. Even one book for one nursing class can cost several hundreds of dollars. Your book expenses could range from a few hundred to upwards of $700 each semester. 

4. TRANSPORTATION COSTS

Nursing school means clinicals, and clinicals means getting there. I’ll never forget my first day of nursing clinicals in the winter weather—I blew a tire as soon as I get down the road, right in front of someone’s driveway, blocking their way to get to work, too. I remember sitting in my car, just sobbing because I didn’t even have money to pay for a new tire.

So, whether you’re driving and have to account for extra mileage, gas, and vehicle maintenance, or have to find a new public transportation route that works for you, don’t forget additional transportation costs in your budget. 

5. CHILDCARE

If you’re a parent, you will most likely need additional childcare not only for your classes and clinical hours, but for your studying outside of school as well. 

6. DECREASED INCOME

In addition to the increased costs you may accumulate during nursing school, you may be faced with decreased income as a result of cutting back on your regular work hours. Although many people have to work during school, many people also have to reduce some of their workloads in order to free up time for classes, clinicals, and studying. 

Resources to Pay For School Costs 

The hidden costs of nursing school may seem discouraging at first, but as a future R.N., you’re resourceful—so here’s how you can make those expenses work within a budget. 

SCHOLARSHIPS

Many people think of scholarships as something you can get at the start of your college journey, but in actuality, you can apply for scholarships as you earn your education too. Remember that sad scene of me crying in the snow with a flat tire that I couldn’t afford? Well, the very next day, I got a check in the mail from a random nursing scholarship that I had applied for—it was just enough to cover the cost of a new tire! Keep applying for all the scholarships you can, even throughout school. Check with your financial aid office for local scholarships, search online, or use a third provider like FastWeb. 

EMPLOYER TUITION ASSISTANCE

If you are currently employed in a healthcare setting, be sure to check with your HR department about any tuition assistance that is available to students. And if you know where you would like to work after graduation, don’t be afraid to ask if they would be willing to work with you in advance—they may be able to offer you some kind of assistance in exchange for a job guarantee at graduation. 

BUY SECONDHAND AND USED

The unfortunate part about required school uniforms is that once you graduate, you probably can’t use those scrubs again—but that does mean that every semester, there is a new crop of new grads who can supply you with scrubs at a discounted (or free!) price. Check if your school offers a Facebook group or used scrub sale at the end of the semester. 

You can also do the same for books, and be sure to check your school’s bookstore for used books before buying new. When I couldn’t afford my nursing school books, I actually used the syllabus to figure out which pages I specifically needed, and copied pages in the library to get through. It’s not a strategy I necessarily recommend, but it costs dollars instead of hundreds of dollars. A lot of books can be purchased as e-books for much cheaper than physical books, too.

Lastly, don’t be afraid to ask your instructors what books they would recommend that you purchase—and which ones could be skipped. I employed this strategy all throughout nursing school and found that almost all of my professors were more than willing to help me save money by helping me prioritize my purchases. 

WORK-STUDY POSITIONS

Work-study jobs are really an ideal situation for a student nurse, because they allow you a set compensation and usually provide you with plenty of time for studying, as well as valuable experience in your field. You may get a work-study position with a nursing professor, for instance, assisting a professor in their duties while studying in your downtime. 

Work-study positions are provided through your financial aid package, so don’t forget to fill out the FAFSA and make sure to update it if anything changes over the course of your education. 

WORKING THE NIGHT SHIFT

You might have to experiment with what works best for you and your schedule (as well as your sanity!), but depending on the clinical area, working night shift might free you up to still earn money—oh and hey, night shift differential—and still make it to class. I speak from experience here and found that the quiet early AM hours also let me squeeze in some studying as well. 

The costs for making it through nursing school can be very different based on your own individual circumstances and although at times, you may have your “flat tire” moment too, just keep in mind—when it comes to investing in a degree that will not only change your own life, but the lives of so many you care for—the work you are putting in now will definitely be worth it.

Source: nurse.org

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Question Of The Day: Gastrointestinal Disorders

Q. A client with an incomplete small-bowel obstruction is to be treated with a Cantor tube. Which of the following measures would most likely be included in the client's care once the Cantor tube has passed into the duodenum?

A. Maintain bed rest with bathroom privileges.
B. Advance the tube 2 to 4 inches at specified times.
C. Avoid frequent mouth care.
D. Provide ice chips for the client to suck.

Correct Answer: B

Reason: Once the intestinal tube has passed into the duodenum, it is usually advanced as ordered 2 to 4 inches every 30 to 60 minutes. This, along with gravity and peristalsis, enables passage of the tube forward. The client is encouraged to walk, which also facilitates tube progression. A client with an intestinal tube needs frequent mouth care to stimulate saliva secretion, to maintain a healthy oral cavity, and to promote comfort regardless of where the tube is placed in the intestine. Ice chips are contraindicated because hypotonic fluid will draw extra fluid into an already distended bowel.

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Question Of The Day: Psychotic Disordersa

Q. The client is taking risperidone (Risperdal) to treat the positive and negative symptoms of schizophrenia. Improvement of which of the following negative symptoms indicate the drug is effective?

A. Abnormal thought form.
B. Hallucinations and delusions.
C. Bizarre behavior.
D. Asocial behavior and anergia.


Correct Answer: D

Reason: Asocial behavior, anergia, alogia, and affective flattening are some of the negative symptoms of schizophrenia that may improve with risperidone therapy. Abnormal thought form is a positive symptom of schizophrenia. Hallucinations and delusions are positive symptoms of schizophrenia. Bizarre behavior is a positive symptom of schizophrenia.

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Question Of The Day: Mood, Adjustment, and Dementia Disorders

Q. The wife of a 67-year-old client who has been taking imipramine (Tofranil) for 3 days asks the nurse why her husband isn't better. The nurse should tell the wife:

A. "It takes 2 to 4 weeks before the full therapeutic effects are experienced."
B. "Your husband may need an increase in dosage."
C. "A different antidepressant may be necessary."
D. "It can take 6 weeks to see if the medication will help your husband."

Correct Answer: A

Reason: Imipramine, a tricyclic antidepressant, typically requires 2 to 4 weeks of therapy before the full therapeutic effects are experienced. Because the client has been taking the drug for only 3 days, it is too soon to determine if the current dosage of imipramine is effective. It is also too soon to consider taking another antidepressant.

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Question Of The Day: Foundations of Psychiatric Nursing

Q. A client diagnosed with pain disorder is talking with the nurse about fishing when he suddenly reverts to talking about the pain in his arm. Which of the following should the nurse do next?

A. Allow the client to talk about his pain.
B. Ask the client if he needs more pain medication.
C. Get up and leave the client.
D. Redirect the interaction back to fishing.

Correct Answer: D

Reason: The nurse should redirect the interaction back to fishing or another focus whenever the client begins to ruminate about physical symptoms or impairment. Doing so helps the client talk about topics that are more therapeutic and beneficial to recovery. Allowing the client to talk about his pain or asking if he needs additional pain medication is not therapeutic because it reinforces the client's need for the symptom. Getting up and leaving the client is not appropriate unless the nurse has set limits previously by saying, "I will get up and leave if you continue to talk about your pain."

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