Nursing Elites

1. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?

• A. Urine is positive for ketones
• B. Urine has an unusual odor
• C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
• D. Bladder scan shows 525 mL of urine

Correct answer: A

Rationale: The correct answer is A. Ketones in the urine may indicate infection or blockage in the urinary catheter, necessitating irrigation to ensure proper drainage. Choice B, an unusual odor in the urine, may suggest infection but does not directly indicate the need for catheter irrigation. Choice C, a high urine specific gravity, is indicative of concentrated urine but does not specifically point to the need for catheter irrigation. Choice D, a bladder scan showing 525 mL of urine, indicates urine retention, which may require catheterization or further assessment but not necessarily irrigation.

2. As a new nurse at a healthcare organization offering a nurse residency program, what would benefit you the most?

• A. Avoiding challenging patient assignments to minimize the risk of errors.
• B. Relying on your clinical preceptor, similar to your relationship with your nurse faculty.
• C. Establishing professional goals based on your clinical knowledge.
• D. Engaging in evidence-based practice projects immediately.

Correct answer: C

Rationale: As a new nurse joining a nurse residency program, the most beneficial action would be to establish professional goals based on your clinical knowledge. Setting clear goals allows you to focus on your learning needs, competency development, and guidance from your clinical preceptor. This proactive approach helps you maximize your learning opportunities, shape your professional growth, and enhance your skills as a novice nurse. Choice A is incorrect because avoiding challenging patient assignments may hinder your learning and skill development. Choice B is incorrect as while the clinical preceptor is essential, solely relying on them without personal professional goals may limit your growth. Choice D is incorrect because engaging in evidence-based practice projects immediately may be overwhelming for a new nurse without first establishing foundational goals.

3. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

• A. Hypotension
• B. Distended neck veins
• C. Slow capillary refill
• D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

4. A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?

• A. Satisficing
• B. Routine
• C. Adaptive
• D. Rationalizing

Correct answer: A

Rationale: The correct answer is A: Satisficing. Satisficing is a decision-making strategy where the person chooses an alternative that is good enough given the circumstances. In this scenario, the nurse manager is making a satisfactory decision by managing the unit with the three remaining nurses to meet minimal staffing standards despite the reduced availability of staff. Choice B, Routine, does not apply as the decision made in the scenario is not part of a regular or standard procedure. Choice C, Adaptive, is not the best fit as the decision is more about making do with the available resources rather than adapting to a new situation. Choice D, Rationalizing, does not align with the scenario as it refers to justifying decisions rather than making a practical choice under constraints.

5.

• A. The patient uses oral contraceptives.
• B. The patient runs several days a week.
• C. The patient has been pregnant three times
• D. The patient has a family history of diabetes

Correct answer: A

Rationale:

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