Nursing Elites

1. When using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?

• A. Position the client in a side-lying position.
• B. Perform the irrigation using a 20-mL syringe.
• C. Instill 15 mL of irrigation fluid into the catheter with each flush.
• D. Measure and record the amount of irrigant used.

Correct answer: B

Rationale: When irrigating an indwelling urinary catheter, the nurse should use a 20-mL syringe for the procedure. This syringe size helps to provide adequate pressure for effective irrigation. Placing the client in a side-lying position is not necessary for this procedure. Instilling a specific amount of irrigation fluid into the catheter is not mentioned in the scenario. Subtracting the amount of irrigant used from the client's urine output is not a standard practice in catheter irrigation.

2. Which of the following is an example of voluntary absenteeism?

• A. Staying home for a sick child
• B. Staying home for a funeral
• C. Staying home to run errands or finish housework
• D. Staying home for sickness

Correct answer: C

Rationale: The correct answer is C, 'Staying home to run errands or finish housework.' Voluntary absenteeism refers to absences that are within the employee's control. Running errands or completing housework are choices an employee makes, unlike being absent due to sickness or a funeral, which are events beyond the employee's control. Choices A, B, and D involve reasons for absence that are not voluntary as they are influenced by external circumstances, such as illness or family emergencies.

3. A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to

• A. save the lunch tray for the patient�s later return to the unit
• B. ask that diagnostic testing area staff to start a 5% dextrose IV
• C. send a glass of milk or orange juice to the patient in the diagnostic testing area
• D. request that if testing is further delayed, the patient be returned to the unit to eat.

Correct answer: D

Rationale:

4. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

5. A new nurse manager is attempting to solve a management issue by using one solution after another until she solves the problem. This would be known as what type of method?

• A. Decision making
• B. Trial and error
• C. Experimentation
• D. Analysis

Correct answer: B

Rationale: The correct answer is B. Trial and error is a method used by new managers to solve problems by trying different solutions until one is successful. In this scenario, the nurse manager is using a trial and error approach by attempting various solutions until the issue is resolved. Choices A, C, and D are incorrect because decision making involves making choices based on available information, experimentation involves testing hypotheses in a controlled setting, and analysis entails examining data and information to gain insights or draw conclusions, none of which directly reflect the iterative process of trial and error.

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