Nursing Elites

1. A nurse manager in the emergency department considers policy changes in the organization and changes in the community, and tries to predict how these may impact the functioning of the unit. Which of the following decisional activities best describes this manager’s actions?

• A. Resource allocation
• B. Monitoring
• C. Job analysis and redesign
• D. Planning for the future

Correct answer: D

Rationale: The correct answer is D: Planning for the future. In this scenario, the nurse manager is engaging in decisional activities related to planning for the future. This involves analyzing potential impacts of policy changes and community shifts on the unit's functioning and making decisions based on predictions and foresight. Option A, resource allocation, focuses on distributing resources effectively. Option B, monitoring, involves observing and assessing current activities. Option C, job analysis and redesign, pertains to evaluating and restructuring roles and responsibilities within the unit, which is not the primary focus of the scenario provided.

2. A client with Graves' disease is prescribed propranolol. The nurse understands that the purpose of this medication is to:

• A. Treat the underlying cause of the disease
• B. Reduce thyroid hormone production
• C. Alleviate symptoms such as tachycardia and tremors
• D. Increase energy levels

Correct answer: C

Rationale: The correct answer is C: Alleviate symptoms such as tachycardia and tremors. Propranolol is a beta-blocker that helps manage symptoms like tachycardia (fast heart rate) and tremors in patients with Graves' disease. Choice A is incorrect because propranolol does not address the underlying cause of Graves' disease, which is autoimmune in nature. Choice B is incorrect because propranolol does not directly reduce thyroid hormone production; it mainly targets the symptoms. Choice D is incorrect because while propranolol may help with symptoms like tachycardia, it is not intended to increase energy levels.

3. A nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which of the following is part of the plan for preparation and administration of the potassium?

• A. Obtaining a controlled IV infusion pump
• B. Monitoring urine output during administration
• C. Diluting an appropriate amount of normal saline
• D. Preparing the medication for bolus administration

Correct answer: D

Rationale: The correct answer is preparing the medication for bolus administration (Choice D). Potassium should never be administered as a bolus because it can cause cardiac arrest. It must always be diluted and given slowly. Obtaining a controlled IV infusion pump (Choice A) is essential for accurate delivery, monitoring urine output during administration (Choice B) helps assess the client's response, and diluting an appropriate amount of normal saline (Choice C) is necessary to prevent irritation and ensure safe administration.

4. Clinical manifestations associated with a diagnosis of type 1 DM include all of the following except:

• A. Hypoglycemia.
• B. Hyponatremia.
• C. Ketonuria.
• D. Polyphagia.

Correct answer: B

Rationale: Clinical manifestations of type 1 diabetes mellitus include hypoglycemia, ketonuria, and polyphagia. Hyponatremia is not typically associated with type 1 diabetes mellitus; it is more commonly linked with other conditions such as syndrome of inappropriate antidiuretic hormone secretion (SIADH) or heart failure. Therefore, the correct answer is B: Hyponatremia.

5. The nurse is caring for a client with DM who is experiencing ketoacidosis. The nurse should prioritize which action?

• A. Administering insulin intravenously.
• B. Giving the client sips of water.
• C. Monitoring the client's urine output.
• D. Applying a heating pad to the client's abdomen.

Correct answer: A

Rationale: Administering insulin intravenously is the priority action for managing diabetic ketoacidosis. Insulin helps lower blood glucose levels and halts the production of ketones, addressing the underlying cause of ketoacidosis. Giving sips of water (Choice B) may be necessary for hydration, but it does not address the immediate life-threatening issue of ketoacidosis. Monitoring urine output (Choice C) is important for assessing renal function but is not the priority over administering insulin. Applying a heating pad (Choice D) is not indicated and can potentially worsen the condition in ketoacidosis.

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