Nursing Elites

1. 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.

2. Which of the following best describes the concept of shared decision-making in healthcare?

• A. The process by which patients make healthcare decisions on their own
• B. A collaborative process that allows patients and providers to make healthcare decisions together
• C. A method for providers to dictate treatment plans to patients
• D. The use of evidence-based guidelines to make healthcare decisions

Correct answer: B

Rationale: The correct answer is B. Shared decision-making in healthcare involves a collaborative process between patients and providers to make healthcare decisions together. This approach considers the patient's preferences, values, and the best available evidence to reach a decision that aligns with the patient's goals. Choice A is incorrect because shared decision-making does not involve patients making decisions on their own. Choice C is incorrect as it describes a paternalistic approach where providers dictate treatment plans to patients without involving them in the decision-making process. Choice D is incorrect as it refers to the use of evidence-based guidelines, which is important but not the sole focus of shared decision-making.

3. The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?

• A. Give the patient 4 to 6 oz more orange juice.
• B. Administer the PRN glucagon (Glucagon) 1 mg IM.
• C. Have the patient eat some peanut butter with crackers.
• D. Notify the healthcare provider about the hypoglycemia.

Correct answer: A

Rationale: The correct action for the nurse to take next is to give the patient 4 to 6 oz more orange juice. The patient's blood glucose has increased from 62 mg/dL to 67 mg/dL after consuming the initial 4 oz of orange juice, indicating that the treatment is effective. Providing additional orange juice will help further raise the blood glucose levels. Administering glucagon (Choice B) is not necessary as the patient's blood glucose is already rising. Having the patient eat peanut butter with crackers (Choice C) is a slower-acting option compared to orange juice. Notifying the healthcare provider about the hypoglycemia (Choice D) is not needed at this point since the patient's blood glucose is improving.

4. 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.

5. 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.

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