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. What is the primary purpose of a nurse staffing committee?

• A. To oversee patient safety initiatives
• B. To develop staffing policies and procedures
• C. To coordinate patient care
• D. To manage nurse recruitment

Correct answer: B

Rationale: The primary purpose of a nurse staffing committee is to develop staffing policies and procedures to ensure adequate nurse-to-patient ratios. By establishing these guidelines, the committee aims to optimize patient care by ensuring appropriate staffing levels, which in turn can enhance patient safety and coordination of care. While overseeing patient safety initiatives and managing nurse recruitment are important aspects of healthcare management, the core function of a nurse staffing committee is to create and implement policies that govern the allocation and distribution of nursing staff to meet patient care needs effectively. Therefore, choices A, C, and D, though relevant to healthcare, do not align with the primary purpose of a nurse staffing committee as outlined in the question.

3. When lifting a bedside cabinet to move it closer to a client, what action should the nurse take to prevent self-injury?

• A. Keep the feet close together.
• B. Use the back muscles for lifting.
• C. Stand close to the cabinet when lifting it.
• D. Bend at the waist.

Correct answer: A

Rationale: The correct answer is A: 'Keep the feet close together.' When lifting a heavy object such as a bedside cabinet, it is essential to maintain a wide base of support by keeping the feet close together. This provides better stability and reduces the risk of injury. Choice B is incorrect because using the back muscles for lifting can lead to back strain and injury; it is recommended to use the legs instead. Choice C is incorrect as standing close to the cabinet may cause the nurse to lose balance and strain the back. Choice D is incorrect because bending at the waist increases the risk of back injury. Therefore, the safest and most appropriate action is to keep the feet close together to ensure stability and prevent self-injury.

4. What should the nurse do after a 36-year-old patient treated with intramuscular glucagon for hypoglycemia regains consciousness?

• A. Assess the patient for symptoms of hyperglycemia.
• B. Give the patient a snack of peanut butter and crackers.
• C. Have the patient drink a glass of orange juice or nonfat milk.
• D. Administer a continuous infusion of 5% dextrose for 24 hours.

Correct answer: B

Rationale: After a patient treated with intramuscular glucagon for hypoglycemia regains consciousness, providing a snack of peanut butter and crackers is essential to prevent another episode of hypoglycemia. Peanut butter and crackers contain a combination of protein and carbohydrates, which can help stabilize the patient's blood glucose levels. This choice is the most appropriate immediate action to prevent recurrence of hypoglycemia in this scenario. Assessing for symptoms of hyperglycemia (choice A) is not the immediate priority after treating hypoglycemia. While orange juice or nonfat milk (choice C) can help raise blood sugar, they lack the sustained effect of protein found in peanut butter. Administering a continuous infusion of dextrose (choice D) is excessive and not indicated after the patient has already regained consciousness.

5. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

• A. give a bolus of 50% dextrose.
• B. insert a large-bore IV catheter.
• C. initiate oxygen via nasal cannula.
• D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

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