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. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?

• A. Urine is positive for ketones
• B. Urine has an unusual odor
• C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
• D. Bladder scan shows 525 mL of urine

Correct answer: A

Rationale: The correct answer is A. Ketones in the urine may indicate infection or blockage in the urinary catheter, necessitating irrigation to ensure proper drainage. Choice B, an unusual odor in the urine, may suggest infection but does not directly indicate the need for catheter irrigation. Choice C, a high urine specific gravity, is indicative of concentrated urine but does not specifically point to the need for catheter irrigation. Choice D, a bladder scan showing 525 mL of urine, indicates urine retention, which may require catheterization or further assessment but not necessarily irrigation.

3. Who is the best person to describe the job to an applicant?

• A. Previous employee
• B. Human resource manager
• C. Nursing manager
• D. Chief operating officer

Correct answer: C

Rationale: The nursing manager is the most suitable person to describe the job to an applicant because they are directly involved in the day-to-day operations and requirements of the position. They have firsthand knowledge of the job responsibilities, expectations, and qualifications needed. Human resource managers are involved in recruitment but may not have the detailed operational knowledge that a nursing manager possesses. A previous employee may provide insights into the work environment but may not have a comprehensive understanding of the current job requirements. The chief operating officer oversees the organization's overall operations and strategy, so they may not have the specific details about the job to effectively describe it to an applicant.

4. Staff are sometimes injured when a patient or visitor becomes agitated. If a staff member reports an injury, the following actions should take place: (EXCEPT)

• A. Notify security.
• B. Complete an incident report.
• C. Notify the nursing supervisor.
• D. Ensure that staff has been examined.

Correct answer: B

Rationale: When a staff member reports an injury resulting from an agitated patient or visitor, several actions should be taken. These actions include notifying security to ensure safety, notifying the nursing supervisor for appropriate follow-up, and ensuring that the injured staff member has been examined to assess the extent of the injury. Completing an incident report is not the correct action to exclude because documenting the incident is crucial for legal and healthcare purposes. Incident reports provide a detailed account of what occurred, which is essential for investigations, insurance claims, and improving safety protocols. Therefore, all other options are necessary steps to take when a staff member reports an injury, making completing an incident report the correct answer for exclusion.

5. What is the primary focus of the Institute for Healthcare Improvement (IHI)?

• A. Patient safety
• B. Cost reduction
• C. Healthcare innovation
• D. Research funding

Correct answer: A

Rationale: The primary focus of the Institute for Healthcare Improvement (IHI) is patient safety. IHI is renowned for its efforts in developing and implementing evidence-based practices to enhance patient safety and improve the quality of care in healthcare settings. While cost reduction, healthcare innovation, and research funding are important aspects of healthcare, the core mission of the IHI revolves around prioritizing patient safety. Patient safety involves reducing medical errors, improving care processes, and creating a safer environment for patients, which are all fundamental to the work of the IHI.

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