Nursing Elites

1. The staff in the emergency department has presented the nurse leader with a suggestion for streamlining the triage process, cutting down on wait times. Which of the following qualities does the leader specifically need to implement the suggestion?

• A. Courage
• B. Integrity
• C. Energy
• D. Initiative

Correct answer: D

Rationale: Initiative is the correct quality needed in this situation. The staff has provided a suggestion for improvement, and the leader must take the initiative to implement it. Courage, integrity, and energy are valuable qualities as well but in this context, the most essential quality is initiative to drive the change forward and improve the triage process efficiently.

2. A postoperative nurse is caring for a client after knee replacement. She discovers the consent was not signed before the surgery. Which of the following charges could be filed?

• A. False imprisonment
• B. Libel
• C. Battery
• D. Malpractice

Correct answer: C

Rationale: The correct answer is C: 'Battery.' Battery could be charged if the consent was not signed before surgery. In this scenario, the lack of signed consent could constitute a case of battery, as the procedure was performed without the patient's explicit permission. Choice A, 'False imprisonment,' does not apply in this context, as it refers to the unlawful confinement of a person. Choice B, 'Libel,' involves making false statements that harm someone's reputation in writing, which is not relevant to the situation described. Choice D, 'Malpractice,' typically refers to professional negligence or failure to meet a standard of care, which is not the primary concern in this case.

3. 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.

4. What is dysfunctional turnover?

• A. Retaining all employees.
• B. Losing employees consistently.
• C. Losing highly skilled employees who are hard to replace.
• D. Hiring new employees.

Correct answer: C

Rationale: Dysfunctional turnover refers to the loss of valuable, skilled employees who are challenging to replace. This turnover can be detrimental to an organization's performance and productivity. Choices A, B, and D are incorrect because dysfunctional turnover specifically involves losing high-quality employees, not retaining all employees, losing employees consistently, or hiring new employees.

5. An RN�s current patient and family have presented her with an ethical dilemma. What is the first step the RN should take to find a workable solution to the problem?

• A. Planning
• B. Assessment
• C. Evaluation
• D. Implementation

Correct answer: B

Rationale: The first step is assessment and identification of the problem.

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