Nursing Elites

1. A client experiences an air emboli, resulting in a stroke, during an IV start. This can be classified as which type of risk?

• A. Patient dissatisfaction
• B. Medical-legal incident
• C. Medication error
• D. Diagnostic procedure

Correct answer: D

Rationale: The correct answer is D, 'Diagnostic procedure.' When a client experiences an air emboli leading to a stroke during an IV start, it falls under the category of a diagnostic procedure risk. This incident occurred during a procedure intended for diagnosis or evaluation. Choices A, B, and C are incorrect. Patient dissatisfaction refers to a client's discontent with care, service, or outcomes; a medical-legal incident involves legal issues related to healthcare practices; and a medication error pertains to mistakes in medication administration.

2. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

3. A unit manager has been working to decrease the incidence of catheter-associated urinary tract infections on his unit, spending extra time on the unit researching best practices and conducting training. Having completed training, the manager decides to take a couple of days off. Which of the following leadership traits is this unit manager displaying?

• A. Perseverance
• B. Balance
• C. Generosity
• D. Ability to handle stress

Correct answer: B

Rationale: The correct answer is 'Balance.' The unit manager is displaying balance by recognizing the importance of taking time off to rest and recharge after working diligently to decrease infections. 'Perseverance' is not the correct choice because the manager is taking time off, not persisting in the face of challenges. 'Generosity' and 'Ability to handle stress' are also incorrect as they do not align with the situation described.

4. After change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

5. Which type of HMO contracts with two or more IPAs (Independent Practice Associations)?

• A. Staff model
• B. Point of service model
• C. Network model
• D. Group model

Correct answer: C

Rationale: The correct answer is C: Network model. A network model of HMOs contracts with two or more IPAs. In a network model, the HMO contracts with multiple IPAs to provide healthcare services to its members, offering a wider range of choices and flexibility in selecting healthcare providers. Choices A, B, and D are incorrect because the staff model involves employing physicians and healthcare providers directly, the point of service model allows members to seek care both in-network and out-of-network, and the group model is not specifically associated with contracting IPAs.

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