Nursing Elites

1. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis?

• A. Elevated blood glucose level and a low plasma bicarbonate
• B. Decreased urine output
• C. Increased respirations and an increase in pH
• D. Comatose state

Correct answer: A

Rationale: The correct answer is A: Elevated blood glucose level and a low plasma bicarbonate. Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, ketosis, and metabolic acidosis, reflected by a low plasma bicarbonate. Elevated blood glucose levels are a hallmark of DKA due to the body's inability to use glucose properly. Choices B, C, and D are incorrect. Decreased urine output is not a specific finding associated with DKA. Increased respirations and an increase in pH are not typical in DKA; in fact, respiratory compensation for the metabolic acidosis in DKA leads to Kussmaul breathing (deep, rapid breathing). A comatose state may occur in severe cases of DKA but is not a confirming finding for the diagnosis.

2. Why might an RN need professional liability insurance?

• A. Protection against frivolous lawsuits without incurring expenses.
• B. Immunity from being sued by the institution if guilty of malpractice.
• C. Coverage for charges of libel, slander, assault, and HIPAA violations.
• D. Exclusively doctors face malpractice lawsuits.

Correct answer: C

Rationale: Having professional liability insurance is crucial for Registered Nurses due to various reasons. Choice A is incorrect because there are expenses associated with defending against frivolous lawsuits. Choice B is incorrect as institutions can still sue a nurse found guilty of malpractice. Choice D is incorrect because malpractice lawsuits can be filed against healthcare professionals, including nurses. Therefore, the correct answer is C, as liability policies can provide coverage for charges involving libel, slander, assault, and breaches of patient confidentiality like HIPAA violations, offering essential protection for RNs in their practice.

3. A new unit manager works hard to get to know each of the staff members on the unit and determine what each staff member needs in order to effectively do their job. What type of management best describes this manager?

• A. Servant leader-style manager
• B. Networking manager
• C. Coaching manager
• D. Monitoring manager

Correct answer: A

Rationale: A Servant leader-style manager focuses on understanding and meeting the needs of staff members to help them grow and perform at their best. This type of manager prioritizes serving the team and facilitating their development. Networking managers focus on building connections and relationships outside the team. Coaching managers provide guidance, support, and feedback to help employees improve. Monitoring managers primarily oversee and supervise tasks without a strong emphasis on individual needs or growth.

4. What is the nurse manager’s role in improving the quality of care on the unit?

• A. The nurse manager is responsible for setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals.
• B. The nurse manager is responsible for monitoring patient outcomes and implementing changes to improve the quality of care on the unit.
• C. The nurse manager is responsible for ensuring that staff members follow established procedures and protocols to maintain the quality of care on the unit.
• D. The nurse manager is responsible for providing feedback and coaching to staff members to help them improve their performance and achieve the unit’s quality goals.

Correct answer: A

Rationale: The nurse manager plays a crucial role in improving the quality of care on the unit by setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals. This involves strategic planning, coordination, and leadership to guide the team in delivering high-quality patient care. Option B is incorrect as while monitoring patient outcomes is important, it is not the primary role of the nurse manager in improving care quality. Option C is incorrect because while ensuring staff adherence to procedures is important, it is a part of maintaining quality rather than actively improving it. Option D is incorrect as providing feedback and coaching, though essential, is not the primary role of the nurse manager in setting goals and priorities for quality improvement.

5. A client with type 2 DM is prescribed metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Avoid taking the medication if you miss a meal.
• D. Take the medication before bedtime.

Correct answer: A

Rationale: The correct instruction when taking metformin (Glucophage) is to take the medication with meals. Taking metformin with meals helps to reduce gastrointestinal side effects and improve absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect because missing a meal does not mean the medication should be avoided; the client should still take it with the next meal. Choice D is incorrect because there is no specific recommendation to take metformin before bedtime.

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