Nursing Elites

1. While caring for a four-year-old female patient who was severely burned in a house fire, how would you determine the extent of this child's burns?

• A. By using the Lund and Browder chart
• B. By using the Rule of Nines
• C. By using the Rule of Tens
• D. By using the Parkland Formula

Correct answer: A

Rationale: The correct answer is A: By using the Lund and Browder chart. The Lund and Browder chart is specifically designed to assess the extent of burns in children accurately, taking into account the variation in body proportions as children grow. This method provides a more precise estimation of the total body surface area affected by burns in pediatric patients. Choices B, C, and D are incorrect. The Rule of Nines is more suitable for adults, not children. The Rule of Tens is not a standard method for assessing burn extent, and the Parkland Formula is used to calculate fluid resuscitation requirements in burn patients, not to determine the extent of burns.

2. Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient?

• A. Intravenous potassium supplementation
• B. Intravenous calcium supplementation
• C. Kidney dialysis
• D. Parenteral nutrition

Correct answer: C

Rationale: The correct answer is C: Kidney dialysis. A blood potassium level of 9.2 mEq/L indicates severe hyperkalemia, which can be life-threatening. Kidney dialysis is the most appropriate intervention to rapidly lower potassium levels in this situation. Choice A, intravenous potassium supplementation, would worsen the hyperkalemia. Choice B, intravenous calcium supplementation, is not the primary intervention for hyperkalemia. Choice D, parenteral nutrition, is unrelated to treating hyperkalemia and would not address the immediate concern.

3. Nurses on an inpatient care unit are working to help reduce unit costs. Which of the following actions is appropriate to include in the cost-containment plan?

• A. Store opened bottles of normal saline in a refrigerator for up to 48 hours.
• B. Return unused supplies from the bedside to the unit's supply stock.
• C. Wait to dispose of sharps containers until they are completely full.
• D. Use clean gloves rather than sterile gloves for colostomy care.

Correct answer: D

Rationale: Using clean gloves rather than sterile gloves for colostomy care is a cost-effective measure without compromising care quality. This choice helps in reducing costs without compromising patient safety. Storing opened bottles of normal saline in a refrigerator for up to 48 hours (Choice A) may lead to contamination risks. Returning unused supplies to the unit's supply stock (Choice B) can be inefficient and lead to potential waste. Waiting to dispose of sharps containers until they are completely full (Choice C) may pose safety hazards and not directly impact cost savings.

4. 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.

5. What is the role of a nurse in a multidisciplinary healthcare team?

• A. Working independently without consulting others
• B. Coordinating patient care with other team members
• C. Ignoring patient concerns
• D. Making all healthcare decisions alone

Correct answer: B

Rationale: The correct answer is B: 'Coordinating patient care with other team members.' In a multidisciplinary healthcare team, nurses collaborate with other healthcare professionals to ensure comprehensive care for patients. Working independently without consulting others (choice A) is not aligned with the collaborative nature of multidisciplinary teams. Ignoring patient concerns (choice C) goes against the core principles of patient-centered care. Making all healthcare decisions alone (choice D) contradicts the teamwork approach of a multidisciplinary team.

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