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1. In which order will the nurse take these steps to prepare NPH 20 units and regular insulin 2 units using the same syringe? (Put a comma and a space between each answer choice [A, B, C, D, E]).
- A. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
- B. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
- C. Rotate NPH vial, Inject 20 units of air into NPH vial, Inject 2 units of air into regular insulin vial, Withdraw regular insulin, Withdraw 20 units of NPH.
- D. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw 20 units of NPH, Inject 2 units of air into regular insulin vial, Withdraw regular insulin.
Correct answer: C
Rationale: The correct order to prepare NPH 20 units and regular insulin 2 units using the same syringe is to start by rotating the NPH vial, then injecting 20 units of air into the NPH vial. Next, inject 2 units of air into the regular insulin vial, followed by withdrawing the regular insulin. Finally, withdraw 20 units of NPH. This sequence ensures proper mixing and preparation of the insulin doses. Choices A, B, and D have incorrect sequences that may lead to incorrect dosages or inadequate mixing of the insulins.
2. Which of the following is an example of an ethical dilemma in nursing?
- A. Choosing between two equally undesirable alternatives
- B. Reporting a colleague's unethical behavior
- C. Balancing patient confidentiality with the need to disclose information
- D. Deciding whether to comply with a patient's request that conflicts with professional ethics
Correct answer: D
Rationale: The correct answer is D. An ethical dilemma in nursing involves deciding whether to comply with a patient's request that conflicts with professional ethics, balancing competing values and principles. Choices A, B, and C do not directly represent ethical dilemmas in nursing. Choice A describes a general ethical dilemma, choice B involves professional conduct rather than a dilemma, and choice C refers to a confidentiality issue rather than conflicting ethical principles.
3. An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?
- A. One or more of the parties may be able to reconcile their values.
- B. The patient�s point of view is recognized as valuable.
- C. The dilemma involves two or more equally unpleasant choices.
- D. The institution is unable to honor the patient�s request.
Correct answer: C
Rationale: An agreement cannot be reached because the dilemma involves two or more equally unpleasant choices.
4. What is the primary goal of a root cause analysis (RCA) in healthcare?
- A. To assign blame for errors
- B. To prevent future errors by identifying underlying causes
- C. To improve patient satisfaction
- D. To analyze the financial impact of errors
Correct answer: B
Rationale: The correct answer is B: 'To prevent future errors by identifying underlying causes.' Root cause analysis (RCA) in healthcare aims to delve deep into the factors contributing to an error to prevent its recurrence. Choice A is incorrect as RCA focuses on identifying system issues, not blaming individuals. Choice C is incorrect as while improving patient satisfaction may result from the process, it is not the primary goal. Choice D is incorrect as the main focus of RCA is not financial analysis but rather improving patient safety.
5. A client experiences an air emboli, resulting in a stroke, during an IV start. This can be classified as which type of risk?
- A. Patient dissatisfaction
- B. Medical-legal incident
- C. Medication error
- D. Diagnostic procedure
Correct answer: D
Rationale: The correct answer is D, 'Diagnostic procedure.' When a client experiences an air emboli leading to a stroke during an IV start, it falls under the category of a diagnostic procedure risk. This incident occurred during a procedure intended for diagnosis or evaluation. Choices A, B, and C are incorrect. Patient dissatisfaction refers to a client's discontent with care, service, or outcomes; a medical-legal incident involves legal issues related to healthcare practices; and a medication error pertains to mistakes in medication administration.
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