Nursing Elites

1. A nurse is assessing a client who reports increased pain following physical therapy. Which of the following questions should the nurse ask when assessing the quality of the client's pain?

• A. Is your pain constant or intermittent?
• B. What would you rate your pain on a scale of 0 to 10?
• C. Does the pain radiate?
• D. Is your pain sharp or dull?

Correct answer: D

Rationale: When assessing the quality of pain, asking if the pain is sharp or dull helps the nurse understand the nature of the pain. Sharp pain is often associated with acute conditions like nerve irritation or injury, while dull pain may indicate a more chronic issue like inflammation or tissue damage. Choices A, B, and C focus on different aspects of pain assessment but do not specifically address the quality of pain, making them less relevant in this context.

2. One of the most useful tools to determine reasons for turnover is:

• A. Questioning.
• B. Surveys.
• C. Employee forums.
• D. Telephone calls.

Correct answer: B

Rationale: Surveys are one of the most effective tools to determine reasons for turnover because they allow employees to provide feedback anonymously, leading to more truthful responses. While questioning can be part of the process, surveys provide a structured and standardized way to collect data. Employee forums may not always elicit honest responses due to peer pressure or fear of repercussions. Telephone calls may not reach all employees and do not guarantee anonymity, potentially leading to biased or incomplete information.

3. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

• A. give a bolus of 50% dextrose.
• B. insert a large-bore IV catheter.
• C. initiate oxygen via nasal cannula.
• D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

4. Which of the following best defines the role of a nurse practitioner (NP)?

• A. Provide direct patient care under the supervision of a physician
• B. Diagnose and treat medical conditions independently
• C. Assist with administrative tasks in a healthcare setting
• D. Specialize in a specific area of nursing practice

Correct answer: B

Rationale: The correct answer is B: 'Diagnose and treat medical conditions independently.' Nurse practitioners (NPs) are advanced practice registered nurses who are qualified to diagnose and treat medical conditions without direct supervision from a physician. Choice A is incorrect because NPs have the autonomy to provide care independently. Choice C is incorrect as NPs focus on clinical care rather than administrative tasks. Choice D is incorrect as specializing in a specific area of nursing practice refers to a different aspect of advanced nursing roles, such as becoming a clinical nurse specialist.

5. A Nurse Manager completes an interruption log and identifies two staff members who take an inordinate amount of time with drop-in issues that are not urgent. What are some methods to address this behavior in an attempt to better manage time? (Select all that apply.)

• A. Designate specific time slots for drop-in visits.
• B. Position the desk chair so it is not facing the hallway.
• C. Communicate with staff about using e-mail for non-urgent matters to improve time management.
• D. When staff members drop in, the manager should stand and remain standing during the conversation.

Correct answer: A

Rationale: Designating specific time slots for drop-in visits helps in managing interruptions effectively by consolidating them into designated periods. This approach allows the Nurse Manager to allocate focused time for addressing these issues without disrupting workflow. Option B, repositioning the desk chair, is not a standard strategy for managing time or interruptions. Option C, promoting the use of e-mail for non-urgent matters, may help in some cases but may not entirely address the behavior of extended drop-in visits. Option D, standing during conversations, may not be practical for longer discussions and does not provide a structured approach to address time management issues.

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