Nursing Elites

1. A nurse is caring for a client who wanders through the halls yelling obscenities at staff, other clients, and visitors. Which of the following actions should the nurse take?

• A. Keep the client in their room with the door closed
• B. Contact a family member to come and sit with the client
• C. Place the client in a wheelchair with a lap tray
• D. Administer a sedative to the client

Correct answer: B

Rationale: When dealing with a client exhibiting disruptive behavior like yelling obscenities, involving a family member can provide emotional support and help in de-escalating the situation. Keeping the client isolated in their room (Choice A) may lead to further agitation. Placing the client in a wheelchair (Choice C) or administering a sedative (Choice D) should not be the first interventions for managing behavioral issues.

2. Which of the following is true regarding the Affordable Care Act?

• A. The Affordable Care Act addressed issues of interest to nursing without controversy.
• B. The Affordable Care Act addressed issues of mandatory overtime, incivility, and high workloads for nurses.
• C. The Affordable Care Act provided a new patient-centered model for health care.
• D. The Affordable Care Act attempted to address many of the issues of interest to nursing, but came with much controversy.

Correct answer: D

Rationale: The correct answer is D. The Affordable Care Act attempted to address many issues relevant to nursing, such as mandatory overtime, incivility, and high workloads, but it faced significant controversy. Choice A is incorrect as the act did not address nursing issues without controversy. Choice B is incorrect as it inaccurately lists the issues the act addressed. Choice C is incorrect as it does not fully capture the controversy surrounding the Affordable Care Act.

3. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should:

• A. Call the physician
• B. Encourage the intake of fluids
• C. Administer the insulin as ordered
• D. Give the client ½ cup of orange juice

Correct answer: C

Rationale: In this scenario, the client with type 1 DM has a high glucose level at bedtime. The appropriate action for the nurse is to administer the sliding scale insulin as ordered. This insulin regimen is specifically designed to manage high blood glucose levels. Calling the physician is not necessary as the protocol for sliding scale insulin is already in place. Encouraging fluid intake or providing orange juice is not the correct intervention for addressing high blood glucose levels in this case.

4. What is a primary responsibility of a healthcare manager?

• A. Direct patient care
• B. Financial oversight
• C. Ignoring staff concerns
• D. Minimizing staff training

Correct answer: B

Rationale: Financial oversight is a primary responsibility of a healthcare manager. Healthcare managers are responsible for managing the financial aspects of healthcare facilities, including budgeting, financial planning, and ensuring financial sustainability. Direct patient care (choice A) is typically the responsibility of healthcare providers such as doctors and nurses, not managers. Ignoring staff concerns (choice C) is counterproductive and goes against effective management practices. Minimizing staff training (choice D) is also not a responsibility of a healthcare manager; on the contrary, they should ensure adequate training and development opportunities for their staff to improve patient care and overall performance.

5. Which statement about glaucoma is true and accurate?

• A. Acute angle-closure glaucoma is an ocular emergency.
• B. Acute angle-closure glaucoma leads to the loss of peripheral vision and tunnel vision.
• C. Primary open-angle glaucoma leads to eye pain, nausea, and vomiting, blurry vision, and halos.
• D. Bubbles are implanted to protect the retina from glaucoma.

Correct answer: A

Rationale: The correct answer is A: 'Acute angle-closure glaucoma is an ocular emergency.' Acute angle-closure glaucoma is indeed considered an ocular emergency that requires immediate attention to prevent vision loss. Choice B is incorrect because acute angle-closure glaucoma commonly presents with symptoms like severe eye pain, headache, blurred vision, and halos around lights. Choice C is incorrect as these symptoms are more indicative of acute angle-closure glaucoma rather than primary open-angle glaucoma. Choice D is incorrect since bubbles are not typically used to protect the retina from glaucoma; treatment usually involves medications, laser therapy, or surgery to manage intraocular pressure.

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