Nursing Elites

1. A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to

• A. save the lunch tray for the patient�s later return to the unit
• B. ask that diagnostic testing area staff to start a 5% dextrose IV
• C. send a glass of milk or orange juice to the patient in the diagnostic testing area
• D. request that if testing is further delayed, the patient be returned to the unit to eat.

Correct answer: D

Rationale:

2. Which of the following is a key principle of the patient-centered care model?

• A. Healthcare provider satisfaction
• B. Cost reduction
• C. Patient autonomy
• D. Provider convenience

Correct answer: C

Rationale: The correct answer is C: Patient autonomy. Patient-centered care focuses on respecting and responding to patient preferences and needs, making patient autonomy a key principle. Choices A, B, and D are incorrect because the patient-centered care model prioritizes the patient's well-being and involvement in decision-making over healthcare provider satisfaction, cost reduction, or provider convenience.

3. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

4. The ANA recommends that nursing in the health care organization change its focus. This requires a shift from a technical model to which of the following?

• A. Professional
• B. Industrial
• C. Random
• D. Organized

Correct answer: A

Rationale: The correct answer is A: Professional. The American Nurses Association (ANA) recommends shifting the focus in healthcare organizations from a technical model to a professional model. This change emphasizes the level of nurse competence required to provide quality care. Choice B, Industrial, is incorrect as it does not align with the focus on professionalism in nursing. Choice C, Random, is unrelated to the context of the question. Choice D, Organized, while a positive attribute, is not the specific focus recommended by the ANA for nursing in healthcare organizations.

5. Staff are sometimes injured when a patient or visitor becomes agitated. If a staff member reports an injury, the following actions should take place: (EXCEPT)

• A. Notify security.
• B. Complete an incident report.
• C. Notify the nursing supervisor.
• D. Ensure that staff has been examined.

Correct answer: B

Rationale: When a staff member reports an injury resulting from an agitated patient or visitor, several actions should be taken. These actions include notifying security to ensure safety, notifying the nursing supervisor for appropriate follow-up, and ensuring that the injured staff member has been examined to assess the extent of the injury. Completing an incident report is not the correct action to exclude because documenting the incident is crucial for legal and healthcare purposes. Incident reports provide a detailed account of what occurred, which is essential for investigations, insurance claims, and improving safety protocols. Therefore, all other options are necessary steps to take when a staff member reports an injury, making completing an incident report the correct answer for exclusion.

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