Nursing Elites

1. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

• A. The patient always carries hard candies when engaging in exercise.
• B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
• C. The patient has a peanut butter sandwich before going for a bicycle ride.
• D. The patient increases daily exercise when ketones are present in the urine.

Correct answer: D

Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

2. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?

• A. Carefully assess and document client status.
• B. Ensure all patient information is secure and the nurse has logged out of the computer before leaving the computer station.
• C. Keep detailed notes while providing care to ensure accurate documentation later in the day.
• D. Discuss safety needs with clients.

Correct answer: A

Rationale: The correct answer is A: 'Carefully assess and document client status.' When dealing with confused clients, it is crucial to assess their status carefully and document it accurately. This helps in avoiding charges of negligence and false imprisonment by ensuring that the client's condition is well-documented and appropriate care is provided. Choice B is incorrect because it focuses on computer security rather than client care. Choice C is incorrect because it emphasizes detailed notes for accuracy but does not specifically address the confusion of clients. Choice D is incorrect as it mentions discussing safety needs but does not directly relate to avoiding charges of negligence and false imprisonment for confused clients.

3. During a discussion about the nursing profession at a middle school, which of the following statements is true?

• A. Nurses need to graduate from nursing school to earn a degree.
• B. Nursing is a profession that values continuous education.
• C. Nurses function autonomously within their scope of practice.
• D. Nurses must adhere to professional behaviors in all aspects of their lives.

Correct answer: C

Rationale: The correct answer is C. Nurses are healthcare professionals who can independently make decisions within their defined scope of practice, providing care to patients. This autonomy allows nurses to assess, diagnose, plan, intervene, and evaluate patient care without direct supervision from physicians. Choice A is incorrect because nurses need to graduate from nursing school to earn a degree, not necessarily to obtain a license. Choice B is incorrect because while continuous education is important in nursing, it is not a defining characteristic of the profession. Choice D is incorrect because while nurses are expected to adhere to professional behaviors, it is not limited to their professional lives but extends to their personal lives as well.

4. A healthcare professional is admitting a client who has rubella. Which of the following types of transmission-based precautions should the nurse initiate?

• A. Airborne
• B. Protective environment
• C. Contact
• D. Droplet

Correct answer: B

Rationale: The correct answer is 'B: Protective environment.' Rubella requires placing the client in a protective environment due to its airborne precautions. Airborne precautions are typically used for diseases that are spread through tiny droplets that remain in the air for an extended period, like tuberculosis. Contact precautions are used for diseases that are spread by direct or indirect contact, such as MRSA. Droplet precautions are implemented for diseases transmitted through respiratory droplets, like influenza. Therefore, in the case of rubella, airborne precautions in a protective environment are necessary.

5. What is the main purpose of a utilization review?

• A. Evaluate patient outcomes
• B. Ensure compliance with regulations
• C. Reduce hospital readmissions
• D. Assess financial impact

Correct answer: A

Rationale: The main purpose of a utilization review is to evaluate patient outcomes and ensure that patients receive appropriate care based on medical necessity and quality standards. While ensuring compliance with regulations, reducing hospital readmissions, and assessing financial impact are important aspects of healthcare management, the primary goal of utilization review is to focus on the quality and effectiveness of patient care.

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