Nursing Elites

1. One of the steps in coaching is often overlooked and taken for granted. What is this step?

• A. Stating the target
• B. Jumping to conclusions
• C. Asking for suggestions
• D. Tying the problem to clients' care

Correct answer: D

Rationale: In coaching, tying the problem to clients' care is crucial but often overlooked. This step ensures that the coach and the client focus on issues directly impacting the client's well-being. Stating the target (choice A) is important but not as critical as tying the problem to clients' care. Jumping to conclusions (choice B) is counterproductive in coaching as it may lead to incorrect assumptions. Asking for suggestions (choice C) is valuable, but it does not address the core aspect of linking the issue to the client's care, which is essential for effective coaching.

2. Which of the following is true of malpractice?

• A. Malpractice occurs when a professional shares information about a patient that could damage that patient�s reputation.
• B. Malpractice is a serious criminal offense.
• C. Malpractice is a minor criminal offense.
• D. Malpractice is a negligent act by an individual whose duties require specialized education.

Correct answer: D

Rationale: Malpractice is a negligent act by an individual whose duties require specialized education.

3. Achieving Magnet Hospital designation offers hospitals the following advantages: (Select all that apply.)

• A. Greater client satisfaction.
• B. Improved nursing recruitment.
• C. Greater client workload.
• D. Nurses who are independent decision makers.

Correct answer: C

Rationale: Achieving Magnet Hospital designation offers hospitals advantages such as improved nursing recruitment and greater nursing retention. The empowered, independent problem-solving nurses resulting from this designation contribute to greater client satisfaction and improved nursing care. Therefore, the correct answer is 'Greater client workload' (C). Choices A, B, and D are incorrect because although they are beneficial outcomes of achieving Magnet Hospital designation, they are not advantages specifically mentioned in the provided rationale.

4. An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?

• A. One or more of the parties may be able to reconcile their values.
• B. The patient�s point of view is recognized as valuable.
• C. The dilemma involves two or more equally unpleasant choices.
• D. The institution is unable to honor the patient�s request.

Correct answer: C

Rationale: An agreement cannot be reached because the dilemma involves two or more equally unpleasant choices.

5. 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.

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