Nursing Elites

1. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
• B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
• C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
• D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

2. There are several pitfalls that should be avoided when using social media of any type. For example, a nurse or student could be found guilty of libel in which of the following scenarios?

• A. Snapping a selfie with a patient
• B. Posting a positive review of the hospital where the student completed clinicals
• C. Creating a closed online forum where students can discuss clinical experiences without providing client information
• D. Complaining about her nurse preceptor on social media, discussing the preceptor�s unprofessional characteristics.

Correct answer: D

Rationale: Statements about individuals encountered in one�s professional or educational life that could damage that person�s reputation may be slander or libel and can be prosecuted as quasi-intentional torts.

3. During a staffing crisis, managers may need to use nurse extenders. These individuals are better known as:

• A. Float RNs.
• B. Unlicensed assistive personnel.
• C. LPNs.
• D. Agency nurses.

Correct answer: B

Rationale: During a staffing crisis, managers may need to utilize unlicensed assistive personnel (UAPs) as nurse extenders. UAPs help free up nurses' time, enabling them to focus more on direct client care. Float RNs (Choice A) refer to registered nurses who work in various units as needed, not specifically as nurse extenders during crises. LPNs (Choice C) are licensed practical nurses, not typically used as nurse extenders. Agency nurses (Choice D) are temporary nurses hired from external agencies, not necessarily designated as nurse extenders.

4. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.

5. Upon noticing a visitor who is loud and active and carrying a gun on the unit where you are in charge, what should you do immediately?

• A. Ask the visitor to leave.
• B. Talk quietly to calm the visitor.
• C. Ask the visitor for the gun.
• D. Notify security with the details of the situation.

Correct answer: D

Rationale: In a situation where a visitor arrives on the unit with a gun, it is essential to prioritize the safety of patients and staff. Immediately notifying security with all the relevant details is the correct course of action. Asking the visitor to leave or engaging them could escalate the situation and put everyone at risk. Similarly, requesting the gun from the visitor directly is not advisable as it could lead to a dangerous confrontation. By alerting security promptly, you enable trained professionals to handle the situation safely and effectively, minimizing risks and ensuring the safety of all individuals involved.

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