Nursing Elites

1. While caring for a client with tuberculosis, which of the following actions should the nurse take?

• A. Use antimicrobial sanitizer for hand hygiene.
• B. Wear a surgical mask when providing client care.
• C. Limit each visitor to 2-hour increments.
• D. Wear gloves when assisting the client with oral care.

Correct answer: A

Rationale: The correct action for the nurse to take when caring for a client with tuberculosis is to use antimicrobial sanitizer for hand hygiene. Tuberculosis is primarily spread through the air, so wearing a surgical mask when providing care (choice B) would be more appropriate for diseases transmitted via droplets. Limiting visitors (choice C) and wearing gloves for oral care (choice D) are important infection control measures but are not specifically tailored to tuberculosis transmission.

2. In which order will the nurse take these steps to prepare NPH 20 units and regular insulin 2 units using the same syringe? (Put a comma and a space between each answer choice [A, B, C, D, E]).

• A. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
• B. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
• C. Rotate NPH vial, Inject 20 units of air into NPH vial, Inject 2 units of air into regular insulin vial, Withdraw regular insulin, Withdraw 20 units of NPH.
• D. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw 20 units of NPH, Inject 2 units of air into regular insulin vial, Withdraw regular insulin.

Correct answer: C

Rationale: The correct order to prepare NPH 20 units and regular insulin 2 units using the same syringe is to start by rotating the NPH vial, then injecting 20 units of air into the NPH vial. Next, inject 2 units of air into the regular insulin vial, followed by withdrawing the regular insulin. Finally, withdraw 20 units of NPH. This sequence ensures proper mixing and preparation of the insulin doses. Choices A, B, and D have incorrect sequences that may lead to incorrect dosages or inadequate mixing of the insulins.

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. What term refers to the situation where the pay of newer employees is similar to or higher than that of more experienced employees?

• A. Salary compression
• B. Salary expectations
• C. Salary range
• D. Salary inflation

Correct answer: A

Rationale: Salary compression is the term used to describe the situation where the pay of newer employees is similar to or higher than that of more experienced employees. This can happen when newer employees are paid higher salaries to attract them, leading to a compressed salary structure in the organization. Choice B, 'Salary expectations,' does not specifically refer to the scenario described in the question. Choice C, 'Salary range,' is a broader term referring to the range of salaries offered for a particular job or position, not specifically related to the disparity between new and experienced employees. Choice D, 'Salary inflation,' does not accurately describe the situation of newer employees earning higher salaries than more experienced ones; instead, it refers to a general increase in wages across the board.

5. What is the primary function of discipline?

• A. To punish
• B. To evaluate
• C. To teach
• D. To ridicule

Correct answer: C

Rationale: The primary function of discipline is to teach individuals appropriate behavior and help them learn from their mistakes. Discipline is meant to guide individuals towards self-improvement and understanding of rules and expectations. Choices A, B, and D are incorrect because discipline is not primarily about punishment, evaluation, or ridicule. While consequences may be a part of discipline, the main goal is to educate and promote positive behavior.

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