Nursing Elites

1. A 27-year-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium level of 3.1 mEq/L. Which action prescribed by the healthcare provider should the nurse take first?

• A. Place the patient on a cardiac monitor
• B. Administer IV potassium supplements
• C. Obtain urine glucose and ketone levels
• D. Start an insulin infusion at 0.1 units/kg/hr

Correct answer: A

Rationale: In a patient with diabetic ketoacidosis (DKA), the initial priority is to assess for any cardiac arrhythmias due to electrolyte imbalances. Since the patient has a low serum potassium level of 3.1 mEq/L, placing the patient on a cardiac monitor is crucial to monitor for any potential cardiac complications. Administering IV potassium supplements (Choice B) may be needed, but it is not the first action to take. Obtaining urine glucose and ketone levels (Choice C) and starting an insulin infusion (Choice D) are important interventions in managing DKA, but ensuring patient safety by monitoring for arrhythmias takes precedence.

2. Which question during the assessment of a diabetic patient will help the nurse identify autonomic neuropathy?

• A.
• B.
• C.
• D.

Correct answer: A

Rationale:

3. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

• A. Lispro (Humalog)
• B. Glargine (Lantus)
• C. Detemir (Levemir)
• D. NPH (Humulin N)

Correct answer: A

Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

4. In the traditional rating scale, what is the time period typically used for evaluation?

• A. Twelve months
• B. Six months
• C. Three months
• D. One month

Correct answer: A

Rationale: In the traditional rating scale, evaluations are typically conducted over a 12-month period. This duration allows for a comprehensive assessment of the employee's performance and progress throughout the year, capturing a broader range of experiences and accomplishments to provide a more holistic evaluation. Choices B, C, and D are incorrect because they do not align with the standard practice of conducting annual evaluations in a traditional rating scale setting.

5. A nurse manager asks the staff to submit written suggestions for a change in policy. The group would then vote on the different suggestions. What type of decision-making technique did the nurse manager use?

• A. Statistical aggregation
• B. Nominal group technique
• C. Brainstorming
• D. Delphi

Correct answer: B

Rationale: The nurse manager used the nominal group technique. This technique involves group members submitting written suggestions, followed by a voting process. Statistical aggregation involves analyzing numerical data, not suggestions. Brainstorming focuses on generating creative ideas collectively, without a structured voting process. Delphi technique involves reaching a consensus through a series of questionnaires or surveys, without a direct voting process.

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