Nursing Elites

1. Cultural diversity presents an important challenge to nurse managers due to which of the following?

• A. A nursing shortage exists
• B. Staff nurses are not trained to be culturally sensitive
• C. 80% of nursing staff comes from one or more minority groups
• D. The increase in cultural diversity is seen both in the patient population and the nursing staff

Correct answer: D

Rationale: Cultural diversity presents an important challenge to nurse managers due to the increase in cultural diversity seen both in the patient population and the nursing staff. This challenge requires nurse managers to ensure that their nursing staff can effectively communicate and provide culturally competent care to patients from diverse backgrounds. Choice A is incorrect because it does not directly relate to the impact of cultural diversity. Choice B is incorrect as it focuses on the training of staff nurses rather than the overall challenge of managing cultural diversity. Choice C is incorrect as the percentage of nursing staff from minority groups, while important, is not the primary reason cultural diversity poses a challenge to nurse managers.

2. Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)?

• A. The patient�s blood glucose level is 174 mg/dL.
• B. The patient has gained 2 lb (0.9 kg) since yesterday.
• C. The patient is scheduled for a chest x-ray in an hour
• D. The patient�s blood urea nitrogen (BUN) level is 52 mg/dL.

Correct answer: D

Rationale:

3. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

• A. Hypotension
• B. Distended neck veins
• C. Slow capillary refill
• D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

4. A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?

• A. Infuse dextrose 50% by slow IV push.
• B. Administer 1 mg glucagon subcutaneously.
• C. Obtain a glucose reading using a finger stick.
• D. Have the patient drink 4 ounces of orange juice.

Correct answer: C

Rationale: The correct action for the nurse to take first when a patient reports feeling lightheaded and sweaty after being weaned off an insulin drip is to obtain a glucose reading using a finger stick. This will provide crucial information on the patient's current blood glucose level, helping the nurse assess if the symptoms are due to hypoglycemia. Based on the glucose reading, appropriate interventions can be initiated, such as administering dextrose, glucagon, or oral sugars like orange juice if hypoglycemia is confirmed. However, verifying the blood glucose level is the initial step to guide subsequent actions and ensure patient safety.

5. What is the primary goal of the Affordable Care Act (ACA)?

• A. To reduce healthcare costs
• B. To expand access to healthcare
• C. To improve healthcare quality
• D. To increase healthcare funding

Correct answer: B

Rationale: The primary goal of the Affordable Care Act (ACA) is to expand access to healthcare. While reducing healthcare costs and improving healthcare quality are important aspects, the ACA's main focus was on increasing the number of Americans with health insurance coverage and enhancing the availability and affordability of healthcare services. Increasing healthcare funding is not the primary goal of the ACA, as its main aim was to make healthcare more accessible and affordable for a larger portion of the population.

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