Nursing Elites

1. A healthcare professional is preparing to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the healthcare professional delegate?

• A. Confirming that a client's pain has decreased after receiving an analgesic
• B. Ambulating a client who is postoperative
• C. Inserting an indwelling urinary catheter for a client
• D. Demonstrating the use of an incentive spirometer to a client

Correct answer: A

Rationale: The correct answer is option A: 'Confirming that a client's pain has decreased after receiving an analgesic.' This task involves assessing the effectiveness of the medication, which can be delegated to the assistive personnel. Options B, C, and D involve skills that should be performed by licensed healthcare professionals due to their complexity and potential risks if not done correctly. Ambulating a postoperative client requires monitoring for signs of distress or complications, inserting a urinary catheter involves an invasive procedure with infection risks, and demonstrating the use of medical devices like an incentive spirometer requires specialized knowledge to ensure correct usage.

2. Which regulatory body mandates the provision of immunizations, especially for hepatitis B?

• A. American Nurses Association (ANA)
• B. Occupational Safety and Health Administration (OSHA)
• C. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
• D. State board of nursing

Correct answer: B

Rationale: The correct answer is B - Occupational Safety and Health Administration (OSHA). OSHA mandates that the hepatitis B vaccine series must be offered to healthcare workers who are not immune to hepatitis. This requirement aims to protect healthcare workers from occupational exposure to bloodborne pathogens, including the hepatitis B virus. The American Nurses Association (ANA) (Choice A) is a professional organization for nurses, not a regulatory body. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (Choice C) focuses on accrediting healthcare organizations for quality and safety, not mandating immunizations. The State board of nursing (Choice D) is responsible for regulating nursing practice within a specific state, not mandating immunizations.

3. An expensive variable in salary budgets is overtime pay. Which of the following is a viable option to reduce overtime?

• A. Limiting overtime for highly paid workers
• B. Reducing the number of beds
• C. Using per diem workers
• D. Refusing to pay overtime

Correct answer: C

Rationale: The correct answer is C: Using per diem workers. By utilizing per diem workers, organizations can flexibly adjust staffing levels based on demand without incurring overtime costs. This approach helps in managing overtime budgets effectively. Choice A is incorrect because limiting overtime for highly paid workers may not address the root cause of overtime expenses. Choice B is incorrect as reducing the number of beds does not directly impact overtime costs. Choice D is not a practical solution as refusing to pay overtime can lead to legal issues and employee dissatisfaction.

4. A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse implement for this client?

• A. Have the client wear a mask when receiving visitors.
• B. Limit the client's time with visitors to no more than 30 minutes per day.
• C. Assign the client to a room with negative-pressure airflow exchange.
• D. Wear a gown when caring for the client.

Correct answer: B

Rationale: The correct answer is B because limiting the client's time with visitors helps prevent the spread of shigella infection to others. Shigella is transmitted through the fecal-oral route, so minimizing contact time reduces the risk of transmission. Choice A is incorrect as there is no need for the client to wear a mask in this situation. Choice C is also incorrect as negative-pressure airflow exchange rooms are typically used for clients with airborne infections. Choice D is incorrect as wearing a gown is not the primary precaution needed for shigella infection.

5. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

• A. Lispro (Humalog)
• B. Glargine (Lantus)
• C. Detemir (Levemir)
• D. NPH (Humulin N)

Correct answer: A

Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

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