Nursing Elites

1. A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?

• A. Infuse dextrose 50% by slow IV push.
• B. Administer 1 mg glucagon subcutaneously.
• C. Obtain a glucose reading using a finger stick.
• D. Have the patient drink 4 ounces of orange juice.

Correct answer: C

Rationale: The correct action for the nurse to take first when a patient reports feeling lightheaded and sweaty after being weaned off an insulin drip is to obtain a glucose reading using a finger stick. This will provide crucial information on the patient's current blood glucose level, helping the nurse assess if the symptoms are due to hypoglycemia. Based on the glucose reading, appropriate interventions can be initiated, such as administering dextrose, glucagon, or oral sugars like orange juice if hypoglycemia is confirmed. However, verifying the blood glucose level is the initial step to guide subsequent actions and ensure patient safety.

2. A supervisor is restricting the flow of communication between staff. This has resulted in the staff having two very opposite directions. The supervisor's actions are known as which type of force?

• A. Opposing force
• B. Driving force
• C. Restraining force
• D. Restrictive force

Correct answer: C

Rationale: The correct answer is C: Restraining force. In this scenario, the supervisor's actions of restricting communication are creating opposing directions among the staff, which is impeding progress and change. Restraining forces work against change by hindering or restricting movement in the desired direction. Choices A, B, and D are incorrect. 'Opposing force' does not specifically address the hindrance caused by the supervisor's actions. 'Driving force' is a positive force that initiates and supports change, which is not the case here. 'Restrictive force' is not a commonly used term in the context of organizational behavior and change management.

3. A nurse is evaluating teaching for a client who has heart failure. Which of the following statements by the client indicates an understanding of the teaching?

• A. I am limiting my sodium intake to 2 grams daily.
• B. I have been weighing myself every other morning.
• C. I am trying to decrease my intake of foods with potassium.
• D. I am eating fewer potato chips and more fruit for snacks.

Correct answer: A

Rationale: The correct answer is A. Limiting sodium intake is crucial for clients with heart failure to manage their condition effectively. Excessive sodium can lead to fluid retention and worsen heart failure symptoms. Weighing oneself is important for monitoring fluid retention but does not directly show an understanding of dietary restrictions. Decreasing potassium intake is not typically recommended for heart failure clients unless specifically advised by a healthcare provider. While choosing healthier snacks is beneficial, the focus on sodium intake is more critical for heart failure management.

4. How did the Social Security Act of 1935 impact public health nursing?

• A. Disabled children
• B. Mentally disabled
• C. Older adults
• D. Opioid addicts

Correct answer: A

Rationale: The Social Security Act of 1935 impacted public health nursing by containing provisions for care for disabled children. This helped in improving the health and well-being of this vulnerable population. The Act did not specifically address care for mentally disabled individuals, older adults, or opioid addicts. Therefore, the correct answer is disabled children.

5. One of the most useful tools to determine reasons for turnover is:

• A. Questioning.
• B. Surveys.
• C. Employee forums.
• D. Telephone calls.

Correct answer: B

Rationale: Surveys are one of the most effective tools to determine reasons for turnover because they allow employees to provide feedback anonymously, leading to more truthful responses. While questioning can be part of the process, surveys provide a structured and standardized way to collect data. Employee forums may not always elicit honest responses due to peer pressure or fear of repercussions. Telephone calls may not reach all employees and do not guarantee anonymity, potentially leading to biased or incomplete information.

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