Nursing Elites

1. A client who had a stroke resulting in aphasia and dysphagia needs assistance. Which of the following tasks should the nurse assign to an assistive personnel (AP)?

• A. Assist the client with a partial bed bath.
• B. Measure the client's BP after the nurse administers an antihypertensive medication.
• C. Test the client's swallowing ability by providing thickened liquids.
• D. Use a communication board to ask what the client wants for lunch.

Correct answer: A

Rationale: The correct answer is A because assisting the client with a partial bed bath is within the scope of practice for an assistive personnel and does not require specialized medical knowledge. Choice B involves measuring BP, which requires specific training and assessment skills that an assistive personnel may not have. Choice C involves testing swallowing ability, which should be done by a healthcare provider due to the risks involved in dysphagia. Choice D involves communication, which is crucial but should be done by someone with training in managing aphasia to ensure effective communication with the client.

2. What is the main focus of the Six Sigma methodology in healthcare?

• A. Reducing healthcare costs
• B. Improving patient satisfaction
• C. Enhancing clinical decision making
• D. Increasing healthcare access

Correct answer: C

Rationale: The main focus of the Six Sigma methodology in healthcare is enhancing clinical decision making through data-driven approaches. By using statistical methods and quality improvement tools, Six Sigma aims to reduce errors, improve processes, and enhance overall decision-making in healthcare settings. While reducing healthcare costs and improving patient satisfaction are important goals, they are not the primary focus of Six Sigma in healthcare. Increasing healthcare access is also a valuable objective but not the main focus of the Six Sigma methodology.

3. Which of the following is an example of a sentinel event?

• A. A patient fall with no injury
• B. A medication error that results in no harm
• C. A patient suicide while in a healthcare facility
• D. A near miss incident

Correct answer: C

Rationale: The correct answer is C, a patient suicide while in a healthcare facility. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury. Choices A, B, and D do not meet the criteria for sentinel events as described by The Joint Commission, as they do not involve death or serious harm to the patient.

4. In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?

• A. First
• B. Second
• C. Third
• D. Fourth

Correct answer: A

Rationale: The correct answer is A: First. In the grievance process, the initial step involves the nurse talking to the nurse manager to address the issue informally. Subsequently, step two entails filing a written appeal to the director of nursing or designee. Step three involves a formal meeting with the employee, agent, grievance chairperson, nursing administrator, and director of human resources. The final step, step four, is arbitration, which is initiated when no mutually acceptable solutions can be reached by the involved parties. Therefore, the nurse talking to the nurse manager about the disagreement is the first step in the grievance process.

5. 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.

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