Nursing Elites

1. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?

• A. Urine is positive for ketones
• B. Urine has an unusual odor
• C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
• D. Bladder scan shows 525 mL of urine

Correct answer: A

Rationale: The correct answer is A. Ketones in the urine may indicate infection or blockage in the urinary catheter, necessitating irrigation to ensure proper drainage. Choice B, an unusual odor in the urine, may suggest infection but does not directly indicate the need for catheter irrigation. Choice C, a high urine specific gravity, is indicative of concentrated urine but does not specifically point to the need for catheter irrigation. Choice D, a bladder scan showing 525 mL of urine, indicates urine retention, which may require catheterization or further assessment but not necessarily irrigation.

2. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?

• A. Urine dipstick for glucose
• B. Oral glucose tolerance test
• C. Fasting blood glucose level
• D. Glycosylated hemoglobin level

Correct answer: D

Rationale: The correct answer is D: Glycosylated hemoglobin level. Glycosylated hemoglobin, also known as hemoglobin A1c, provides a long-term indicator of blood glucose control over the past 2-3 months. It is a valuable tool in assessing the effectiveness of diabetes treatment because it reflects average blood sugar levels during this period. Choices A, B, and C are not as effective for evaluating long-term glucose control. Urine dipstick for glucose only provides a snapshot of glucose levels at the time of testing, oral glucose tolerance test evaluates how the body processes glucose after drinking a sugary solution, and fasting blood glucose level gives a point-in-time measurement of glucose levels after fasting, but they do not reflect the overall glucose control over several months.

3. A registered nurse (RN) administered a patient�s morning insulin as the breakfast tray arrived at 0800. The RN performed a complete assessment at the same time. Then, the RN got busy with her other patients and did not check on the patient until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. Which of the following could the RN be charged with?

• A. Quasi-intentional tort
• B. Misdemeanor
• C. Negligence
• D. Juvenile offense

Correct answer: C

Rationale: Negligence is the failure to act in a reasonable, ordinary, and prudent manner, causing harm to someone who is owed the duty to care.

4. Which of the following behaviors would be an early warning sign that you are not handling job stress in a healthy way?

• A. Focusing excessively on patient outcomes
• B. Needing to spend more time alone
• C. Juggling work, studies, and family responsibilities
• D. Awakening in the morning feeling unrested

Correct answer: D

Rationale: The correct answer is D. Awakening in the morning feeling unrested can be an early warning sign that you are not handling job stress in a healthy way. This may indicate that the stress is impacting your quality of sleep, which is essential for managing stress and maintaining overall well-being. Choices A, B, and C are not necessarily indicative of unhealthy stress management. Focusing excessively on patient outcomes may show dedication to work, needing to spend more time alone could be a personal preference, and juggling work, studies, and family responsibilities could be a common challenge that many individuals face.

5. In a multiple-car accident with multiple trauma clients being sent to an Emergency Department, which type of leadership would be most effective in this situation?

• A. Democratic
• B. Bureaucratic
• C. Laissez-faire
• D. Autocratic

Correct answer: D

Rationale: In a high-stress situation like a multiple-car accident with multiple trauma clients arriving at the Emergency Department, autocratic leadership is most effective. This type of leadership allows for clear direction and quick decision-making, crucial in managing emergencies. Democratic leadership may slow down the decision-making process due to the need for consensus. Bureaucratic leadership focuses on following established rules and procedures, which may not be flexible enough in an emergency. Laissez-faire leadership, characterized by a hands-off approach, is not suitable in urgent situations where immediate action is required.

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