Nursing Elites

1. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?

• A. Document the surgeon's instructions in the client's medical record.
• B. Complete an incident report.
• C. Consult the charge nurse.
• D. Notify the nursing manager.

Correct answer: D

Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.

2. A new manager is implementing an initiative with the desired outcome of having the unit run more smoothly. What quality is the manager demonstrating?

• A. Being unrealistic
• B. Being a change agent
• C. Being democratic
• D. Being authoritarian

Correct answer: B

Rationale: The correct answer is B: Being a change agent. The manager is demonstrating the quality of being a change agent by implementing an initiative aimed at improving the unit's operations. A change agent initiates and drives changes to enhance effectiveness and efficiency within the unit. Choice A is incorrect because the manager's actions are not described as unrealistic but rather proactive. Choice C, being democratic, is incorrect as it does not relate to the manager's initiative to improve unit operations. Choice D, being authoritarian, is also incorrect as the manager is not described as enforcing changes through strict control and power.

3. An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?

• A. Hemoglobin A1C level 6.2%
• B. Blood pressure 146/88 mmHg
• C. Heart rate at rest 58 beats/minute
• D. High-density lipoprotein (HDL) level 65 mg/dL

Correct answer: B

Rationale: The correct answer is B. In a young adult with type 1 diabetes, a blood pressure of 146/88 mmHg may indicate the need for a change in therapy as it is above the recommended target levels. High blood pressure can increase the risk of cardiovascular complications in diabetic patients. Choices A, C, and D are within normal ranges and do not necessarily indicate the need for an immediate change in therapy. A Hemoglobin A1C level of 6.2% is generally considered good control for a diabetic patient, a resting heart rate of 58 beats/minute is normal for an active individual, and an HDL level of 65 mg/dL is considered to be in the desirable range for heart health.

4. Which of the following laws govern nursing practice?

• A. Statutory laws
• B. Common law
• C. Administrative laws
• D. Constitutional laws

Correct answer: A

Rationale: Statutory laws are laws created by legislative bodies, such as state legislatures. In the context of nursing practice, statutory laws govern areas like licensure requirements, scope of practice, and professional standards. Common law, choice B, is based on court decisions and precedents, not specifically related to nursing practice. Administrative laws, choice C, deal with regulations set by administrative agencies rather than governing nursing practice directly. Constitutional laws, choice D, pertain to the fundamental principles outlined in a country's constitution and are not specific to regulating nursing practice.

5. Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)

• A. Notify the nursing supervisor.
• B. Notify security.
• C. Have them check patients to verify safety.
• D. Ask construction workers to be responsible.

Correct answer: D

Rationale: When construction is ongoing in a healthcare setting, it is essential to address safety concerns promptly. While it is crucial to notify the nursing supervisor and security to manage potential risks, having staff check patients for safety is also a valid precautionary measure. However, asking construction workers to be responsible is not a proper action to address the safety concerns posed by the equipment. Construction workers are professionals responsible for their tasks; it is the healthcare facility's responsibility to ensure patient and staff safety in such situations.

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