Nursing Elites

1. An RN is explaining to a student nurse what professionalism in nursing means. Which of the following statements, if made by the student nurse, demonstrates teaching has been successful?

• A. Commitment to others means I should be honest and accountable for my actions.
• B. I should encourage my fellow nurses to talk when they are having a bad day.
• C. I should be flexible with myself and my fellow nurses when it comes to the dress code.
• D. If I need a day off, I should promptly call in sick to give my manager plenty of time to find a replacement.

Correct answer: A

Rationale:

2. What behaviors can be observed before a person becomes violent? (EXCEPT)

• A. Wandering
• B. Tense shoulders and clenched fists
• C. Blank stare
• D. Positioned with one foot in back and an arm pulled back

Correct answer: A

Rationale: Before a person becomes violent, observable behaviors may include tense shoulders, clenched fists, a blank stare, and being positioned with one foot in back and an arm pulled back. Wandering is not typically associated with threatening behaviors signaling imminent violence. DelBel (2003) suggests that strategies such as relaxed body language, maintaining physical distance, and silence can help de-escalate an agitated individual's response.

3. What is the main focus of the Magnet Recognition Program?

• A. Nurse satisfaction
• B. Patient outcomes
• C. Financial performance
• D. Nursing excellence

Correct answer: D

Rationale: The main focus of the Magnet Recognition Program is nursing excellence. While nurse satisfaction and patient outcomes are important aspects influenced by the program, the primary goal is to recognize and promote nursing excellence. Financial performance is not the main focus of this program.

4. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

5. When a client with a terminal diagnosis asks about advance directives, what should the nurse do?

• A. Engage the client and ask why they want to discuss this without their partner present.
• B. Provide information on advance directives and offer brochures.
• C. Advise the client to schedule a discussion with their provider.
• D. Focus on the client's current feelings and postpone planning for a later time.

Correct answer: A

Rationale: Choice A is the correct response as it demonstrates active listening and empathy by engaging the client in a discussion about their concerns regarding advance directives. It also recognizes the importance of involving the client's partner in such discussions, promoting shared decision-making and support. Choices B and C lack the personalized approach needed in this situation and do not address the client's immediate request for information. Choice D is incorrect as it disregards the client's expressed need to discuss advance directives and focuses solely on their current feelings, delaying a crucial conversation.

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