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1. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?
- A. The patient always carries hard candies when engaging in exercise.
- B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
- C. The patient has a peanut butter sandwich before going for a bicycle ride.
- D. The patient increases daily exercise when ketones are present in the urine.
Correct answer: D
Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.
2. What is the main goal of a nursing quality improvement (QI) program?
- A. To enhance patient safety
- B. To reduce healthcare costs
- C. To ensure regulatory compliance
- D. To maintain high patient satisfaction
Correct answer: A
Rationale: The main goal of a nursing quality improvement (QI) program is to enhance patient safety. While reducing healthcare costs, ensuring regulatory compliance, and maintaining high patient satisfaction are important aspects of healthcare delivery, the primary focus of a QI program in nursing is to improve patient safety through practices such as error reduction, risk management, and enhancing the quality of care provided.
3. What is the primary role of a nurse mentor?
- A. To supervise nursing staff
- B. To provide emotional support
- C. To guide new nurses in their roles
- D. To enforce policy compliance
Correct answer: C
Rationale: The primary role of a nurse mentor is to guide new nurses in their roles. This involves providing support, sharing knowledge and expertise, offering guidance for professional development, and assisting new nurses in adjusting to their roles and responsibilities. Option A, supervising nursing staff, is more aligned with a nurse manager's responsibilities rather than a mentor's. Option B, providing emotional support, is a part of the mentorship role but not the primary focus. Option D, enforcing policy compliance, is essential but not the primary role of a mentor, as mentoring focuses more on nurturing and developing new nurses.
4. 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.
5. 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.
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