Nursing Elites

1. A client with frequent tonic-clonic seizures is being admitted. What action should the nurse add to the client's plan of care?

• A. Ensure blankets are placed on all four sides of the bed.
• B. Refrain from using restraints during seizure activity.
• C. Position the client laterally during seizure activity.
• D. Have a tongue depressor available at the client's bedside.

Correct answer: D

Rationale: The correct action the nurse should add to the client's plan of care is to have a tongue depressor available at the client's bedside. This is important during a seizure to prevent the client from biting their tongue. Placing the client laterally helps maintain a clear airway and prevents aspiration, making choice C a good practice during seizure activity. Using restraints during a seizure can cause injuries and should be avoided, making choice B incorrect. Wrapping blankets around all four sides of the bed is unnecessary for seizure management and does not contribute to the client's safety during a seizure, making choice A incorrect.

2. A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?

• A. Infuse dextrose 50% by slow IV push.
• B. Administer 1 mg glucagon subcutaneously.
• C. Obtain a glucose reading using a finger stick.
• D. Have the patient drink 4 ounces of orange juice.

Correct answer: C

Rationale: The correct action for the nurse to take first when a patient reports feeling lightheaded and sweaty after being weaned off an insulin drip is to obtain a glucose reading using a finger stick. This will provide crucial information on the patient's current blood glucose level, helping the nurse assess if the symptoms are due to hypoglycemia. Based on the glucose reading, appropriate interventions can be initiated, such as administering dextrose, glucagon, or oral sugars like orange juice if hypoglycemia is confirmed. However, verifying the blood glucose level is the initial step to guide subsequent actions and ensure patient safety.

3. What is a benefit of effective delegation?

• A. It increases the manager's workload
• B. It allows the manager to make all the decisions
• C. It empowers staff to make decisions
• D. It decreases staff involvement

Correct answer: C

Rationale: The correct answer is C: 'It empowers staff to make decisions.' Effective delegation involves entrusting tasks and decisions to staff, which not only lightens the manager's load but also empowers employees, enhancing their skills and confidence. Choice A is incorrect because effective delegation should reduce the manager's workload by distributing tasks appropriately. Choice B is incorrect as effective delegation involves empowering staff to make decisions rather than the manager making all decisions. Choice D is incorrect as effective delegation actually increases staff involvement by giving them more responsibilities and decision-making power.

4. What is the major difference between managers and leaders?

• A. Leaders usually have legitimate power.
• B. Leaders do not necessarily make good managers.
• C. Managers are not always leaders.
• D. Managers always have legitimate power.

Correct answer: D

Rationale: The major difference between managers and leaders is that managers always have legitimate power. This is because managers derive their authority from their position within an organization, giving them legitimate power over subordinates. On the other hand, leaders do not always have legitimate power; their influence may come from various sources such as expertise, charisma, or the ability to inspire others. Choice A is incorrect because not all leaders necessarily have legitimate power. Choice B is incorrect as it is a generalization that leaders do not make good managers, which is not always the case. Choice C is incorrect as there can be managers who are also effective leaders.

5. The nurse manager is responsible for implementing a new electronic health record (EHR) system. What is the first step in this process?

• A. Train all staff on the new system
• B. Identify the project team
• C. Develop a training program
• D. Conduct a needs assessment

Correct answer: B

Rationale: The correct first step in implementing a new electronic health record (EHR) system is to identify the project team. This team will be crucial in overseeing the entire implementation process, including tasks like developing a training program (Choice C) and conducting a needs assessment (Choice D). Training all staff on the new system (Choice A) is an important step but typically occurs after the project team has been identified to ensure a smooth and efficient implementation.

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