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 best describes the role of a nurse leader?

• A. Managing patient care directly
• B. Enforcing healthcare policies
• C. Inspiring and motivating the healthcare team
• D. Ensuring regulatory compliance

Correct answer: C

Rationale: The correct answer is C: 'Inspiring and motivating the healthcare team.' Nurse leaders play a crucial role in fostering a positive and collaborative work environment by motivating and inspiring their team members. Choice A is incorrect because managing patient care directly is typically the responsibility of staff nurses, while nurse leaders focus on leadership and coordination. Choice B is incorrect as enforcing healthcare policies is usually a function of compliance officers or administrators. Choice D is also incorrect as ensuring regulatory compliance is important but is usually overseen by compliance officers or regulatory affairs specialists, not specifically the role of a nurse leader.

3. A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to

• A. save the lunch tray for the patient�s later return to the unit
• B. ask that diagnostic testing area staff to start a 5% dextrose IV
• C. send a glass of milk or orange juice to the patient in the diagnostic testing area
• D. request that if testing is further delayed, the patient be returned to the unit to eat.

Correct answer: D

Rationale:

4. 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.

5. 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.

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