Nursing Elites

1. Which of the following is the best argument for lower patient-to-nurse ratio?

• A. The more patients a nurse has, the better the nurse will be at catching early warning signs.
• B. Greater patient-to-nurse ratios decrease patient mortality.
• C. Adequate nurse levels do not impact the prevalence of urinary tract infections.
• D. Community nursing ratios do not impact Methicillin-resistant Staphylococcus aureus (MRSA) rates.

Correct answer: B

Rationale: The best argument for lower patient-to-nurse ratios is that they decrease patient mortality. Choice A is incorrect because having more patients can lead to increased workload and decreased attention per patient. Choice C is incorrect as adequate nurse levels can indeed impact the prevalence of infections. Choice D is incorrect as community nursing ratios can impact MRSA rates due to potential transmission risks in healthcare settings.

2. A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet delivered the oxygen tank. Which of the following actions should the nurse take?

• A. Send an oxygen tank from the facility home with the client
• B. Instruct the client's family to contact the insurance provider about the oxygen equipment
• C. Contact social services about the delivery of the oxygen equipment
• D. Notify the provider about the delayed oxygen tank delivery

Correct answer: C

Rationale: The correct action for the nurse to take is to contact social services about the delivery of the oxygen equipment. This ensures that the necessary equipment is delivered to the client's home promptly. Choice A is incorrect because sending an oxygen tank from the facility is not a sustainable solution and may lead to legal and safety issues. Choice B is incorrect as contacting the insurance provider is not the appropriate course of action to address the delayed delivery. Choice D is also incorrect because notifying the provider about the delay may not directly lead to the timely delivery of the oxygen equipment.

3. Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select one that does not apply.

• A. The nurse could have given the insulin subcutaneously.
• B. The nurse did not have to contact the physician.
• C. The nurse should have used regular insulin (Humulin R).
• D. The nurse used the correct insulin.

Correct answer: C

Rationale: The best evaluation of the nurse reveals that she should have used regular insulin (Humulin R) for IV administration. Regular insulin is the only insulin approved for intravenous administration due to its pharmacokinetic properties. Insulin lispro (Humalog) is not suitable for IV use. Choice A is incorrect because giving insulin intravenously is necessary in this case of high blood sugar. Choice B is incorrect because administering a different insulin without consulting the physician is not appropriate. Choice D is incorrect because the nurse used the incorrect insulin, which could pose risks to the client's health.

4. A nurse enters a client room to witness an informed consent for a gastroscopy. The client states he does not understand the procedure. Which of the following actions should the nurse take?

• A. Educate the client about the risks of refusing medications
• B. Complete an incident report
• C. Answer the client's question concerning the procedure
• D. Inform the provider that the client requires clarification about the procedure

Correct answer: D

Rationale: The correct action for the nurse to take in this situation is to inform the provider that the client requires clarification about the procedure. This ensures that the client fully understands the gastroscopy procedure before giving consent. Choice A is incorrect as the client's issue is not about refusing medications. Choice B is irrelevant as there is no incident to report. Choice C could be misleading as the nurse should not be providing information about the procedure but rather ensuring that the client gets the necessary clarification from the provider.

5. You have just learned that another nurse was fired for taking photographs of patients without their permission using a cell phone and posting them on Facebook. This nurse was fired because the nurse had:

• A. Violated the law
• B. Acted in a negligent manner
• C. Not completed the proper documentation
• D. Violated an ethical principle

Correct answer: A

Rationale: The correct answer is A: Violated the law. Taking and sharing patient photographs without consent is a violation of patient privacy laws, hence the nurse was fired for breaking the law. Choice B, acting in a negligent manner, is incorrect as the nurse's actions were intentional and not due to negligence. Choice C, not completing proper documentation, is unrelated to the situation described. Choice D, violating an ethical principle, is not specific enough as the primary reason for the nurse's termination was the legal breach regarding patient privacy.

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