Nursing Elites

1. A 26-year-old patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to administer the morning insulin?

• A. Thigh
• B. Buttock
• C. Abdomen
• D. Upper arm

Correct answer: C

Rationale: The correct answer is the abdomen. When a patient engages in physical activities like riding a bicycle, the abdomen is a suitable site for insulin administration due to the consistent absorption rate. The subcutaneous tissue in the abdomen allows for more predictable insulin absorption compared to other sites. The thigh is also a common site for insulin injection but may not be ideal for this patient due to the physical activity involved. The buttock and upper arm are not preferred sites for insulin injection as they can have variable absorption rates and may not be as convenient for self-administration.

2. Monitoring the number of times a medication is given utilizing the 'five rights' is an example of which phase of the Six Sigma program?

• A. Measure
• B. Management
• C. Quantitative
• D. Goal

Correct answer: A

Rationale: In the Six Sigma program, the 'Measure' phase focuses on monitoring and measuring processes to ensure they meet the desired standards. This includes tracking the number of times a medication is given correctly using the 'five rights' principle. Therefore, the correct answer is A. Choice B, 'Management,' does not specifically relate to monitoring processes or data collection, so it is not the correct answer. Choice C, 'Quantitative,' refers to the use of numerical data in decision-making, which is a broader concept and not specific to monitoring processes within the Six Sigma framework. Choice D, 'Goal,' is too general and does not capture the specific phase of Six Sigma that involves monitoring and measuring processes.

3. What should the nurse do after a 36-year-old patient treated with intramuscular glucagon for hypoglycemia regains consciousness?

• A. Assess the patient for symptoms of hyperglycemia.
• B. Give the patient a snack of peanut butter and crackers.
• C. Have the patient drink a glass of orange juice or nonfat milk.
• D. Administer a continuous infusion of 5% dextrose for 24 hours.

Correct answer: B

Rationale: After a patient treated with intramuscular glucagon for hypoglycemia regains consciousness, providing a snack of peanut butter and crackers is essential to prevent another episode of hypoglycemia. Peanut butter and crackers contain a combination of protein and carbohydrates, which can help stabilize the patient's blood glucose levels. This choice is the most appropriate immediate action to prevent recurrence of hypoglycemia in this scenario. Assessing for symptoms of hyperglycemia (choice A) is not the immediate priority after treating hypoglycemia. While orange juice or nonfat milk (choice C) can help raise blood sugar, they lack the sustained effect of protein found in peanut butter. Administering a continuous infusion of dextrose (choice D) is excessive and not indicated after the patient has already regained consciousness.

4. Which of the following is true regarding health care systems today?

• A. They are all managed care organizations.
• B. They are all privately owned.
• C. Only HMOs are profitable.
• D. There are multiple types of organizations.

Correct answer: D

Rationale: The correct answer is D: 'There are multiple types of organizations.' This statement is true as there are various health care delivery systems in today's world, including but not limited to managed care organizations, privately owned facilities, and other models. Choices A, B, and C are incorrect because not all health care systems are managed care organizations, privately owned, or only profitable if they are HMOs. Health care systems can vary in ownership, management, and profitability, making choice D the most accurate.

5. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation that should be included in the reminders for ensuring legally credible nursing documentation is to 'Only use approved abbreviations.' Using shortcuts in documentation (Choice A) may lead to incomplete or vague information, compromising the credibility of documentation. Documentation should not be subjective (Choice C) but rather objective and based on factual information. While it is important to document after care is provided (Choice D), the immediate documentation following care provision is critical for accuracy and legal credibility.

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