Nursing Elites

1. When using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?

• A. Position the client in a side-lying position.
• B. Perform the irrigation using a 20-mL syringe.
• C. Instill 15 mL of irrigation fluid into the catheter with each flush.
• D. Measure and record the amount of irrigant used.

Correct answer: B

Rationale: When irrigating an indwelling urinary catheter, the nurse should use a 20-mL syringe for the procedure. This syringe size helps to provide adequate pressure for effective irrigation. Placing the client in a side-lying position is not necessary for this procedure. Instilling a specific amount of irrigation fluid into the catheter is not mentioned in the scenario. Subtracting the amount of irrigant used from the client's urine output is not a standard practice in catheter irrigation.

2. After change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

3. What is the main purpose of a patient satisfaction survey?

• A. To improve patient outcomes
• B. To evaluate nursing performance
• C. To measure patient satisfaction
• D. To assess healthcare facilities

Correct answer: C

Rationale: The main purpose of a patient satisfaction survey is to measure patient satisfaction. These surveys aim to gather feedback directly from patients regarding their experiences and perceptions of the healthcare services they have received. While patient satisfaction may impact outcomes indirectly, the primary goal of the survey is not to directly improve patient outcomes, making choice A incorrect. Choice B is incorrect because patient satisfaction surveys are not primarily focused on evaluating nursing performance specifically. Choice D is also incorrect because the main focus of the survey is on the satisfaction of patients rather than assessing healthcare facilities.

4. 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.

5. What is the primary role of a nurse in an interdisciplinary team?

• A. To lead the healthcare team
• B. To advocate for the patient
• C. To provide emotional support to the patient
• D. To ensure compliance with regulations

Correct answer: B

Rationale: The correct answer is B: 'To advocate for the patient.' Nurses play a crucial role in interdisciplinary teams by ensuring that the patient's needs and preferences are considered in the care plan. While leadership (Choice A) can be a part of a nurse's responsibilities in certain situations, the primary role is patient advocacy. Providing emotional support (Choice C) is important but not the primary role in an interdisciplinary team. Ensuring compliance with regulations (Choice D) is important but not the primary focus when working within an interdisciplinary team.

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