Nursing Elites

1. The healthcare provider is assessing a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory findings is most consistent with this condition?

• A. Increased serum sodium
• B. Decreased urine specific gravity
• C. Decreased serum osmolality
• D. Increased serum potassium

Correct answer: C

Rationale: The correct answer is C: Decreased serum osmolality. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. The dilution of sodium results in decreased serum osmolality. Option A is incorrect because SIADH causes hyponatremia, resulting in decreased serum sodium levels. Option B is incorrect because SIADH leads to concentrated urine with increased urine specific gravity. Option D is incorrect as SIADH does not typically affect serum potassium levels.

2. Which of the following traits is characteristic of a caring leader?

• A. A caring leader serves first and leads second.
• B. A caring leader is aware of the feelings of others.
• C. The traits of a caring leader include respecting coworkers as individuals and empathizing with the needs and concerns of others.
• D. A caring leader is fair and honest.

Correct answer: C

Rationale: A caring leader is characterized by respecting coworkers as individuals and empathizing with their needs and concerns. Choice A is more about servant leadership rather than specifically about caring leadership. Choice B, while related to empathy, does not encompass the full spectrum of traits associated with a caring leader. Choice D, being fair and honest, is important in leadership but does not solely define a caring leader.

3. A patient with acute congestive heart failure is receiving high doses of a diuretic. On assessment, the nurse notes flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. Suspecting hyponatremia, what additional signs would the nurse expect to note in this patient if hyponatremia were present?

• A. Dry skin
• B. Decreased urinary output
• C. Hyperactive bowel sounds
• D. Increased specific gravity of the urine

Correct answer: C

Rationale: In a patient with hyponatremia, hyperactive bowel sounds are expected due to increased gastrointestinal motility. Dry skin (Choice A) is not a typical sign of hyponatremia. Decreased urinary output (Choice B) is more commonly associated with conditions like dehydration or renal issues, not specifically hyponatremia. Increased specific gravity of the urine (Choice D) is a sign of concentrated urine, which is not a characteristic finding in hyponatremia.

4. A nurse manager is working to improve patient satisfaction on the unit. Which of the following best describes the nurse manager’s role in this process?

• A. The nurse manager should set clear expectations for patient satisfaction, monitor progress, and provide feedback to staff members to continuously improve patient care.
• B. The nurse manager should gather data on patient satisfaction, identify areas for improvement, and implement strategies to enhance the patient experience.
• C. The nurse manager should develop a patient satisfaction improvement plan, set measurable goals, and track progress over time to ensure continuous improvement.
• D. The nurse manager should involve patients and families in the patient satisfaction improvement process, gather feedback, and use it to make improvements to care delivery.

Correct answer: A

Rationale: The correct answer is A. The nurse manager's role in improving patient satisfaction involves setting clear expectations for patient satisfaction, monitoring progress, and providing feedback to staff members to continuously improve patient care. Choice B is incorrect as gathering data and implementing strategies are typically part of quality improvement initiatives but do not solely define the nurse manager's role. Choice C is incorrect because the nurse manager is responsible for setting expectations and monitoring progress rather than developing the improvement plan. Choice D is incorrect as involving patients and families and gathering feedback are important aspects, but the question specifically asks about the nurse manager's role, which primarily involves setting expectations, monitoring progress, and providing feedback to staff.

5. What is the nurse manager’s role in improving the quality of care on the unit?

• A. The nurse manager is responsible for setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals.
• B. The nurse manager is responsible for monitoring patient outcomes and implementing changes to improve the quality of care on the unit.
• C. The nurse manager is responsible for ensuring that staff members follow established procedures and protocols to maintain the quality of care on the unit.
• D. The nurse manager is responsible for providing feedback and coaching to staff members to help them improve their performance and achieve the unit’s quality goals.

Correct answer: A

Rationale: The nurse manager plays a crucial role in improving the quality of care on the unit by setting goals and priorities for the unit and ensuring that staff members are working towards achieving those goals. This involves strategic planning, coordination, and leadership to guide the team in delivering high-quality patient care. Option B is incorrect as while monitoring patient outcomes is important, it is not the primary role of the nurse manager in improving care quality. Option C is incorrect because while ensuring staff adherence to procedures is important, it is a part of maintaining quality rather than actively improving it. Option D is incorrect as providing feedback and coaching, though essential, is not the primary role of the nurse manager in setting goals and priorities for quality improvement.

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