Nursing Elites

1. A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?

• A. Increase in hematocrit
• B. Increase in respiratory rate
• C. Decrease in heart rate
• D. Decrease in capillary refill time

Correct answer: D

Rationale: The correct answer is D: Decrease in capillary refill time. In a client with fluid volume deficit, improving capillary refill time indicates that the perfusion status is improving due to the increase in fluid volume. Choices A, B, and C are incorrect. An increase in hematocrit may indicate hemoconcentration due to fluid loss, an increase in respiratory rate may suggest respiratory distress, and a decrease in heart rate may not be directly related to fluid volume status.

2. If the nurse and nurse manager did not resolve the situation related to the physician's report about the nurse's performance, what is the length of time allowed for the nurse to submit an appeal?

• A. 10 days
• B. 15 days
• C. 20 days
• D. 30 days

Correct answer: A

Rationale: If the informal discussion between the nurse and nurse manager does not resolve the issue regarding the physician's report on the nurse's performance, the nurse can submit a written appeal within 10 days, according to the healthcare facility policy. This 10-day timeframe ensures a prompt resolution of disputes and maintains clear communication channels within the healthcare setting. Choices B, C, and D are incorrect as they exceed the time limit allowed for the nurse to submit an appeal, which is specified to be 10 days.

3. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?

• A. BUN 21 mg/dL (10 to 20 mg/dL)
• B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
• C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
• D. Sodium 132 mEq/L (136 to 145 mEq/L)

Correct answer: B

Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.

4. What is the primary focus of a performance appraisal for nursing staff?

• A. To identify areas for salary increases
• B. To evaluate overall job performance
• C. To provide feedback on clinical skills
• D. To determine eligibility for promotions

Correct answer: C

Rationale: The primary focus of a performance appraisal for nursing staff is to provide feedback on clinical skills, identify areas for improvement, and support professional development. While salary increases, overall job performance evaluation, and promotions may be factors considered during a performance appraisal, the primary goal is to assess and enhance clinical skills to ensure high-quality patient care.

5. Which of the following is a key principle of team nursing?

• A. Decentralized decision making
• B. Centralized decision making
• C. Individual accountability
• D. Shared responsibility

Correct answer: D

Rationale: The correct answer is D: 'Shared responsibility.' Team nursing emphasizes shared responsibility among team members for patient care. This approach promotes collaboration and coordination among healthcare professionals to deliver comprehensive and holistic care. Choices A and B are incorrect because team nursing typically involves collaborative decision-making rather than centralized or decentralized decision-making. Choice C, 'Individual accountability,' does not align with the collaborative nature of team nursing, where responsibility is shared among team members rather than falling solely on individuals.

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