Nursing Elites

1. Which patient action indicates a good understanding of the nurse�s teaching about the use of an insulin pump?

• A. The patient programs the pump for an insulin bolus after eating
• B. The patient changes the location of the insertion site every week
• C. The patient takes the pump off at bedtime and starts it again each morning.
• D. The patient plans for a diet that is less flexible when using the insulin pump.

Correct answer: A

Rationale:

2. The Hawthorne effect explains that the relationship between people and productivity is enhanced by which of the following?

• A. Special attention
• B. Organizations
• C. Creativity
• D. Groups

Correct answer: A

Rationale: The Hawthorne effect is a term used to describe how people modify their behavior in response to the attention they are receiving rather than the manipulation of variables. Special attention, as mentioned in choice A, is the correct answer because when individuals feel that they are being closely monitored or that special interest is being taken in them, they tend to perform better or change their behavior. Choices B, C, and D are incorrect because the Hawthorne effect specifically focuses on the impact of attention and not on organizational structures, creativity, or group dynamics.

3. Even though this is not easy, facilitating ____________ is a mandatory skill for all nurse managers and is crucial in the success of the manager.

• A. resistance
• B. change
• C. planning
• D. collection of data

Correct answer: B

Rationale: The correct answer is 'B: change.' Facilitating change is a crucial skill for nurse managers as they often need to lead and manage changes in healthcare settings. While managing resistance (choice A) is important, the question focuses on the necessity of facilitating change. Planning (choice C) and collecting data (choice D) are also essential skills for managers, but in this context, the emphasis is on the ability to facilitate change effectively.

4. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

5. A registered nurse (RN) administered a patient�s morning insulin as the breakfast tray arrived at 0800. The RN performed a complete assessment at the same time. Then, the RN got busy with her other patients and did not check on the patient until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. Which of the following could the RN be charged with?

• A. Quasi-intentional tort
• B. Misdemeanor
• C. Negligence
• D. Juvenile offense

Correct answer: C

Rationale: The RN could be charged with negligence.

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