Nursing Elites

1. The staff nurse delegates AM care for two patients to the UAP (Unlicensed Assistive Person). What principle of delegation is the nurse following?

• A. Delegation requires a situation with clearly defined superiors.
• B. Delegation can only exist with a subordinate.
• C. Delegation is a tool used by various healthcare professionals.
• D. You can delegate only those tasks.

Correct answer: D

Rationale: The correct answer is D: 'You can delegate only those tasks.' Delegation in nursing involves transferring responsibility for the performance of a task while retaining accountability for the outcome. The principle of delegation does not require a situation with clearly defined superiors (choice A). Delegation can exist not only with a subordinate but also with colleagues or other healthcare team members (choice B). Delegation is not exclusive to nurses and is a tool used by various healthcare professionals (choice C). Therefore, the best choice is D as it accurately reflects the principle of delegation in nursing.

2. Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)

• A. Notify the nursing supervisor.
• B. Notify security.
• C. Have them check patients to verify safety.
• D. Ask construction workers to be responsible.

Correct answer: D

Rationale: When construction is ongoing in a healthcare setting, it is essential to address safety concerns promptly. While it is crucial to notify the nursing supervisor and security to manage potential risks, having staff check patients for safety is also a valid precautionary measure. However, asking construction workers to be responsible is not a proper action to address the safety concerns posed by the equipment. Construction workers are professionals responsible for their tasks; it is the healthcare facility's responsibility to ensure patient and staff safety in such situations.

3. 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.

4. A nurse manager is preparing the budget for the year. The budgeted amounts have been set without regard to changes that may occur during the year. What type of budget is the manager preparing?

• A. Fixed budget
• B. Zero-based budget
• C. Variable budget
• D. Operating budget

Correct answer: A

Rationale: The correct answer is A: Fixed budget. A fixed budget is one where the budgeted amounts are set without considering changes that may occur during the year. This type of budget is based on the assumption that the business environment will remain stable. Choice B, Zero-based budget, involves setting the budget at zero and justifying all expenses. Choice C, Variable budget, adjusts based on changes in activity levels. Choice D, Operating budget, is a comprehensive projection of all revenue and expenses for the upcoming period.

5. Which statement by the patient indicates a need for additional instruction in administering insulin?

• A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
• B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
• C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
• D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'

Correct answer: A

Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.

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