Nursing Elites

1. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

2. Which of the following is a characteristic of a well-written goal?

• A. Goals should be vague
• B. Goals should be unrealistic
• C. Goals need to be measurable, realistic, and achievable
• D. Goals should be easy to achieve

Correct answer: C

Rationale: The correct answer is C: Goals need to be measurable, realistic, and achievable. Well-written goals should be specific and quantifiable to provide clear direction and motivation. Choice A is incorrect as goals should not be vague but rather specific. Choice B is incorrect as goals should be realistic to be attainable. Choice D is incorrect as goals should challenge individuals and not be too easy to achieve to promote growth and development.

3. Several factors are considered in the calculation of the amount of FTEs. Which of the following is NOT considered when calculating the FTEs?

• A. Hours of care provided
• B. Ancillary staff
• C. Procedures to be done
• D. Types of patients

Correct answer: A

Rationale: When calculating Full-Time Equivalents (FTEs), factors such as the hours of work for the staff for two weeks, average daily census, and types of patients are considered. However, the hours of care provided are not typically included in the calculation of FTEs. Therefore, the correct answer is A. Choice B, ancillary staff, can impact FTE calculations as they contribute to the overall workload. Choice C, procedures to be done, can also influence FTE calculations, especially if they affect staffing requirements. Choice D, types of patients, play a role in determining the level of care needed and subsequently impact FTE calculations.

4. Which of the following best describes the concept of value-based healthcare?

• A. Focusing on the volume of services provided
• B. Maximizing hospital revenue
• C. Improving clinical outcomes while controlling costs
• D. Emphasizing patient satisfaction

Correct answer: C

Rationale: The correct answer is C. Value-based healthcare focuses on improving clinical outcomes while controlling costs. It emphasizes quality over quantity, aiming to provide efficient and effective care that enhances patient health outcomes while managing expenses. Choices A and B are incorrect because value-based healthcare is not about focusing on the volume of services provided or maximizing hospital revenue. Choice D, emphasizing patient satisfaction, is also not the primary focus of value-based healthcare, which prioritizes clinical outcomes and cost control.

5. 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.

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