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. 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.

3. 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.

4. When planning a budget, the nurse manager knows that costs depend on and change in direct proportion to patient volume and activity. What type of costs are these?

• A. Variable costs
• B. Indirect costs
• C. Fixed costs
• D. Direct costs

Correct answer: A

Rationale: Variable costs vary in direct proportion to patient volume and activity. These costs increase or decrease based on the level of patient care provided. Indirect costs are not directly tied to patient volume, fixed costs remain constant regardless of patient volume, and direct costs are directly attributable to patient care but may not vary with patient volume and activity. Therefore, the correct answer is 'Variable costs.'

5. Your nurse manager talks with you once per week to determine how you are adjusting to your role as a new nurse. She asks if you feel that you are able to provide good care to your patients, whether you are becoming familiar with the electronic health record, and whether your preceptor is encouraging your independence. This manager is demonstrating:

• A. An intrusive style.
• B. An effort to understand if you are coping with the demands.
• C. An attempt to intimidate.
• D. An authoritarian style.

Correct answer: B

Rationale: The correct answer is B. The nurse manager is showing an effort to understand if you are coping with the demands of your new role as a nurse. This approach demonstrates empathy and concern for your well-being and professional development. Choices A, C, and D are incorrect because there is no indication of intrusion, intimidation, or authoritarian behavior in the manager's actions. Instead, the manager is engaging in supportive and constructive communication to help you adjust and grow in your new position.

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