Nursing Elites

1. 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.

2. What is the main focus of the Six Sigma methodology in healthcare?

• A. Reducing healthcare costs
• B. Improving patient satisfaction
• C. Enhancing clinical decision making
• D. Increasing healthcare access

Correct answer: C

Rationale: The main focus of the Six Sigma methodology in healthcare is enhancing clinical decision making through data-driven approaches. By using statistical methods and quality improvement tools, Six Sigma aims to reduce errors, improve processes, and enhance overall decision-making in healthcare settings. While reducing healthcare costs and improving patient satisfaction are important goals, they are not the primary focus of Six Sigma in healthcare. Increasing healthcare access is also a valuable objective but not the main focus of the Six Sigma methodology.

3. Which of the following is an example of a sentinel event?

• A. A patient fall with no injury
• B. A medication error that results in no harm
• C. A patient suicide while in a healthcare facility
• D. A near miss incident

Correct answer: C

Rationale: The correct answer is C, a patient suicide while in a healthcare facility. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury. Choices A, B, and D do not meet the criteria for sentinel events as described by The Joint Commission, as they do not involve death or serious harm to the patient.

4. What is the main purpose of a clinical audit?

• A. To measure patient satisfaction
• B. To evaluate the effectiveness of clinical practices
• C. To identify areas for improvement
• D. To standardize patient care protocols

Correct answer: C

Rationale: The main purpose of a clinical audit is to identify areas for improvement in clinical practices. While patient satisfaction might be a component evaluated during an audit, the primary goal is to ensure that care is safe, effective, and patient-centered, rather than solely focusing on satisfaction. Evaluating the effectiveness of clinical practices is a related but more specific goal compared to the broader aim of identifying areas for improvement. Standardizing patient care protocols can be a result of a clinical audit, but it is not the main purpose, which is to pinpoint areas needing enhancement.

5. Which of the following is used as an indirect estimate of voluntary absenteeism?

• A. Involuntary absenteeism
• B. Voluntary absenteeism
• C. Total time lost
• D. Absence frequency

Correct answer: D

Rationale: The correct answer is 'Absence frequency.' Absence frequency is the total number of distinct absence periods, regardless of duration. It is used as an indirect estimate of voluntary absenteeism because it provides insights into the frequency of absences. Voluntary absenteeism refers to absences that are under the employee's control, while involuntary absenteeism is not under their control. Total time lost, on the other hand, represents the number of scheduled days that employees miss, which is different from absence frequency.

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