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. The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which patient statement indicates a need for additional teaching?

• A. �If I overeat at a meal, I will still take the usual dose of medication.�
• B. �Other medications besides the Glucotrol may affect my blood sugar.�
• C. �When I am ill, I may have to take insulin to control my blood sugar.�
• D. �My diabetes won�t cause complications because I don�t need insulin.�

Correct answer: D

Rationale:

3. What is the primary focus of strategic planning in healthcare organizations?

• A. Financial performance
• B. Staff satisfaction
• C. Patient care quality
• D. Regulatory compliance

Correct answer: C

Rationale: In healthcare organizations, the primary focus of strategic planning is to enhance patient care quality. While financial performance, staff satisfaction, and regulatory compliance are essential aspects in healthcare management, they are secondary to the overarching goal of providing high-quality care to patients. Financial performance ensures sustainability, staff satisfaction impacts productivity and retention, and regulatory compliance maintains legal standards. However, without a core focus on improving patient care quality, the strategic planning efforts may not align with the primary mission of healthcare organizations.

4. Lippitt's phases of change are important factors in the change process. The phase that involves key people in data collection is known as:

• A. Assess the motivation.
• B. Choose a change agent.
• C. Diagnose the problem.
• D. Maintain the change.

Correct answer: C

Rationale: The correct answer is C: 'Diagnose the problem.' In Lippitt's phases of change, the first step is to diagnose the problem, which involves key people in data collection and problem-solving. This step is crucial as it helps identify the root causes of the issues that need to be addressed. Assessing the motivation (A) comes later in the change process once the problem has been diagnosed. Choosing a change agent (B) and maintaining the change (D) are also important steps in the change process but do not specifically involve key people in data collection as in the diagnosis phase.

5. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision-makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the ethical decision-making process, after identifying the decision-makers involved, the next step is typically planning. During the planning stage, the RN will consider the available options, weigh the ethical principles involved, and develop a course of action to address the ethical dilemma. Choice A, Assessment, involves gathering information and data about the situation. Choice B, Diagnosis, involves analyzing the gathered information to identify the ethical issue. Choice D, Implementation, comes after planning and involves putting the chosen course of action into practice.

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