Nursing Elites

1. A nurse is comparing the rate of medication errors on the medical unit to the rate from a medical unit in a magnet hospital. Which of the following quality improvement methods is the nurse using?

• A. Structure audit
• B. Benchmarking
• C. Risk benefit analysis
• D. Root cause analysis

Correct answer: B

Rationale: The correct answer is B: Benchmarking. Benchmarking involves comparing performance metrics with those from other units or institutions, which is exactly what the nurse is doing by comparing the rate of medication errors on their medical unit to the rate from a medical unit in a magnet hospital. Choice A, Structure audit, is not relevant to this scenario as it focuses on assessing the physical, organizational, or procedural structures in a healthcare setting. Choice C, Risk benefit analysis, involves weighing the potential risks and benefits of a particular course of action, not comparing performance metrics. Choice D, Root cause analysis, is a method used to identify the underlying causes of problems or adverse events, not to compare performance metrics between units.

2. A nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which of the following clinical manifestations would the nurse expect to note in the client?

• A. Twitching
• B. Positive Trousseau's sign
• C. Hyperactive bowel sounds
• D. Hyperactive deep tendon reflexes

Correct answer: A

Rationale: The correct answer is A: Twitching. Hypocalcemia often presents with neuromuscular irritability, leading to manifestations such as twitching. Trousseau's sign is actually a positive indicator of hypocalcemia, not negative, making choice B incorrect. Hypoactive bowel sounds are not typically associated with hypocalcemia, making choice C incorrect. Similarly, hypoactive deep tendon reflexes are not a common finding in hypocalcemia, making choice D incorrect.

3. A nurse is preparing to discharge a client who has end-stage heart failure. The client's partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take?

• A. Request another family member to assist the client's partner with care
• B. Recommend the partner to place the client in a long-term care facility
• C. Contact the case manager to discuss discharge options
• D. Ask the provider to delay the client's discharge home for a few more days

Correct answer: C

Rationale: The nurse should contact the case manager to discuss discharge options and support the client's partner. This action is appropriate as it involves seeking professional guidance and support for the client's partner who is struggling to care for the client. Option A is not the best choice as it solely focuses on involving another family member without addressing the partner's concerns directly. Option B is premature as recommending long-term care should be a well-considered decision involving multiple healthcare professionals. Option D delays the inevitable without providing a solution to the partner's current challenges.

4. Which statement about adjuvant medications is true and accurate?

• A. Licensed practical nurses can administer adjuvant medications.
• B. Adjuvant medications are schedule 2 narcotics.
• C. Adjuvant medications are schedule 1 narcotics.
• D. Adjuvant medications can be purchased over the counter.

Correct answer: D

Rationale: The correct answer is D because adjuvant medications are often available over the counter without a prescription. Choices A, B, and C are incorrect. Choice A is incorrect because licensed practical nurses can administer adjuvant medications depending on their scope of practice. Choices B and C are incorrect because adjuvant medications are not classified as schedule 1 or schedule 2 narcotics.

5. Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select one that does not apply.

• A. It stimulates the pancreas to produce more insulin.
• B. It must be taken after meals.
• C. It decreases sugar production in the liver.
• D. It inhibits absorption of carbohydrates.

Correct answer: A

Rationale: The correct choice that does not apply is A. Metformin does not stimulate the pancreas to produce more insulin; instead, it works by decreasing sugar production in the liver, inhibiting carbohydrate absorption, and reducing insulin resistance. It is recommended to take metformin with meals to reduce gastrointestinal side effects. Option B is incorrect as metformin is usually taken with meals. Option D is also incorrect as metformin does not inhibit the absorption of carbohydrates.

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