Nursing Elites

1. What should the nurse do after a 36-year-old patient treated with intramuscular glucagon for hypoglycemia regains consciousness?

• A. Assess the patient for symptoms of hyperglycemia.
• B. Give the patient a snack of peanut butter and crackers.
• C. Have the patient drink a glass of orange juice or nonfat milk.
• D. Administer a continuous infusion of 5% dextrose for 24 hours.

Correct answer: B

Rationale: After a patient treated with intramuscular glucagon for hypoglycemia regains consciousness, providing a snack of peanut butter and crackers is essential to prevent another episode of hypoglycemia. Peanut butter and crackers contain a combination of protein and carbohydrates, which can help stabilize the patient's blood glucose levels. This choice is the most appropriate immediate action to prevent recurrence of hypoglycemia in this scenario. Assessing for symptoms of hyperglycemia (choice A) is not the immediate priority after treating hypoglycemia. While orange juice or nonfat milk (choice C) can help raise blood sugar, they lack the sustained effect of protein found in peanut butter. Administering a continuous infusion of dextrose (choice D) is excessive and not indicated after the patient has already regained consciousness.

2. The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions would be which of the following strategies?

• A. Verifying through feedback
• B. Follow-up communication
• C. Getting positive attention
• D. Knowing the context of the instruction

Correct answer: A

Rationale: Asking the subordinate to repeat the instructions is a strategy known as verifying through feedback. This approach ensures that the receiver has understood the request correctly. Choice B, 'Follow-up communication,' refers to checking in after the initial communication, not necessarily asking for repetition. Choice C, 'Getting positive attention,' is unrelated to confirming understanding. Choice D, 'Knowing the context of the instruction,' deals with understanding the background or reasons behind the instructions, not confirming comprehension.

3. What is the primary goal of evidence-based practice (EBP)?

• A. Reduce healthcare costs
• B. Improve patient outcomes
• C. Enhance clinical decision making
• D. Ensure patient safety

Correct answer: C

Rationale: The primary goal of evidence-based practice (EBP) is to enhance clinical decision making by integrating the best available evidence with clinical expertise and patient values. While improving patient outcomes is a significant result of EBP, the ultimate aim is to ensure that healthcare decisions are based on the most current, relevant, and reliable evidence. While reducing healthcare costs and ensuring patient safety are important in healthcare, they are not the primary goals of evidence-based practice.

4. Nurse Managers work with staff to educate them about ways to diffuse potentially violent situations. Which of the following diagnoses can staff expect to be more frequently associated with violence?

• A. Alcohol or drug withdrawal
• B. Anxiety
• C. Depression
• D. Confusion

Correct answer: A

Rationale: Alcohol or drug withdrawal is more frequently associated with violence as these conditions alter a person's inhibitions. Gilmore (2006) highlights that working with the public involves inherent risks and stressors. Individuals with head trauma, mental illnesses, and those withdrawing from substances are more likely to respond with violence. Anxiety, depression, and confusion do not typically lead to increased violent behavior compared to conditions involving substance withdrawal.

5. In our culturally diverse society, barriers to health care result from:

• A. Prejudice
• B. Different socioeconomic status
• C. Differences in language
• D. All of the above

Correct answer: D

Rationale: In a culturally diverse society, barriers to health care can stem from various factors. These include differences in language, various socioeconomic statuses, and prejudices. These factors can create obstacles for individuals in accessing healthcare services. Therefore, the correct answer is 'All of the above' as all the provided choices contribute to barriers in healthcare access. Choice A, 'Prejudice,' is correct as biases and discrimination can prevent individuals from receiving proper care. Choice B, 'Different socioeconomic status,' is accurate as financial disparities can limit access to healthcare services. Choice C, 'Differences in language,' is also valid as language barriers can hinder effective communication and understanding between patients and healthcare providers.

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