Nursing Elites

1. A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?

• A. ''I had a bowel movement, but I was able to save the urine.''
• B. ''I have a specimen in the bathroom from about 30 minutes ago.''
• C. ''I drink a lot, so I will fill up the bottle and complete the test quickly.''
• D. ''I flushed what I urinated at 7:00 a.m. and have saved all urine since.''

Correct answer: C

Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.

2. A nurse manager is considering the variances of the budget. Fewer monies were spent than expected. What type of variance is this?

• A. Unfavorable variance
• B. Favorable variance
• C. Dependent variance
• D. Independent variance

Correct answer: B

Rationale: The correct answer is B, favorable variance. When fewer funds are spent than expected, it indicates efficient budget management, making it a favorable outcome. Choice A, unfavorable variance, is incorrect as it would apply if more money than expected was spent. Choices C and D, dependent variance and independent variance, are unrelated terms in the context of budget variances and do not apply to the situation described.

3. 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: Satisficing is the correct decision-making strategy in this scenario. The nurse manager is not aiming for the best solution but rather choosing an alternative that is good enough given the circumstances of staff shortage. Choice B, Routine, does not apply here as the situation is not part of the manager's regular tasks. Choice C, Adaptive, involves adjusting to new conditions, which is not the primary focus in this scenario. Choice D, Rationalizing, does not fit as the decision made is more about finding an acceptable solution rather than justifying it.

4. Why is increasing the use of advanced practice nurses encouraged?

• A. A 2010 Institute of Medicine report recommended nurses practice to the full extent of their education.
• B. Advanced practice nurses act as an extension of physicians.
• C. The National League for Nursing advocates for the master of science in nursing (MSN) as the terminal degree for nurse practitioners.
• D. Advanced practice nurses lack the skills to diagnose.

Correct answer: A

Rationale: The correct answer is A because the 2010 Institute of Medicine report recommended that nurses practice to the full extent of their education, which includes utilizing advanced practice nurses. This supports the efficient delivery of healthcare services by leveraging the expertise and skills of advanced practice nurses. Choice B is incorrect as it describes the role of advanced practice nurses rather than providing a reason for increasing their use. Choice C is unrelated to the encouragement of increasing the use of advanced practice nurses as it focuses on the terminal degree for nurse practitioners. Choice D is incorrect as advanced practice nurses do possess the skills necessary to diagnose and provide advanced care, so the statement that they lack diagnostic skills is inaccurate.

5. Which of the following best defines the role of a nurse practitioner (NP)?

• A. Provide direct patient care under the supervision of a physician
• B. Diagnose and treat medical conditions independently
• C. Assist with administrative tasks in a healthcare setting
• D. Specialize in a specific area of nursing practice

Correct answer: B

Rationale: The correct answer is B: 'Diagnose and treat medical conditions independently.' Nurse practitioners (NPs) are advanced practice registered nurses who are qualified to diagnose and treat medical conditions without direct supervision from a physician. Choice A is incorrect because NPs have the autonomy to provide care independently. Choice C is incorrect as NPs focus on clinical care rather than administrative tasks. Choice D is incorrect as specializing in a specific area of nursing practice refers to a different aspect of advanced nursing roles, such as becoming a clinical nurse specialist.

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