Nursing Elites

1. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?

• A. BUN 21 mg/dL (10 to 20 mg/dL)
• B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
• C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
• D. Sodium 132 mEq/L (136 to 145 mEq/L)

Correct answer: B

Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.

2. When looking at the issue surrounding absenteeism, an innovative approach would be:

• A. Rewarding those who do not use days.
• B. Substituting personal days.
• C. Termination.
• D. Disciplinary actions.

Correct answer: B

Rationale: The correct answer is B. Substituting personal days for sick days can be considered an innovative approach to addressing absenteeism as it allows for proper planning by the nurse manager. This approach promotes a proactive and flexible solution that encourages employees to manage their time off more effectively. Choice A, rewarding those who do not use days, may not address the root causes of absenteeism and could create a culture of presenteeism. Choices C and D, termination and disciplinary actions, are punitive measures that do not focus on preventive strategies or address the underlying reasons for absenteeism.

3. What is the primary goal of a clinical nurse leader (CNL)?

• A. To manage the nursing staff
• B. To coordinate patient care
• C. To improve patient outcomes
• D. To implement evidence-based practices

Correct answer: C

Rationale: The primary goal of a clinical nurse leader (CNL) is to improve patient outcomes by overseeing patient care delivery, coordinating with healthcare team members, and ensuring quality care. While managing nursing staff (choice A) and implementing evidence-based practices (choice D) are important aspects of a CNL's role, the ultimate focus is on enhancing patient outcomes. Coordinating patient care (choice B) is part of the CNL's responsibilities but not the primary goal.

4. A ___________ manager supervises a number of first-level managers, usually within related specialties.

• A. self-directed
• B. first-level
• C. middle-level
• D. self-motivated

Correct answer: C

Rationale: A middle-level manager is responsible for overseeing a group of first-level managers who handle day-to-day operations within their respective specialties. Middle-level managers play a crucial role in coordinating and aligning the efforts of multiple first-level managers to achieve organizational goals. They act as a bridge between top management and frontline employees, ensuring that strategies are effectively implemented at the operational level. Choice A, 'self-directed,' refers to an individual's ability to manage their own work without direct supervision and does not specifically relate to supervising other managers. Choice B, 'first-level,' describes the managers being supervised, not the position responsible for overseeing them. Choice D, 'self-motivated,' pertains to an individual's drive and determination, which is not directly related to the hierarchical level of management being discussed.

5. A nurse is caring for a client who reports difficulty falling asleep. Which of the following recommendations should the nurse make?

• A. Watch a television program in bed before going to sleep.
• B. Drink a cup of hot cocoa before bedtime.
• C. Maintain a consistent time to wake up each day.
• D. Exercise 1 hour before going to bed.

Correct answer: C

Rationale: The correct answer is C: "Maintain a consistent time to wake up each day." Establishing a regular wake-up time helps regulate the body's internal clock and promotes better sleep patterns. Watching television in bed (Choice A) can actually hinder sleep due to the light emitted by screens affecting melatonin production. Drinking beverages with caffeine like hot cocoa (Choice B) close to bedtime can interfere with falling asleep. Exercising vigorously right before bed (Choice D) can increase alertness and make it harder to fall asleep.

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