Nursing Elites

1. Attending a continuing education class on advanced technology in health care is interpreted as which of the following by the nurse manager?

• A. Only important for nurse managers
• B. Not important
• C. A waste of time
• D. Essential to nursing care

Correct answer: D

Rationale: The correct answer is D: 'Essential to nursing care.' Advancements in technology play a crucial role in modern healthcare delivery. By attending a class on advanced technology, the staff nurse can enhance their skills and knowledge, ultimately benefiting nursing care. Choices A, B, and C are incorrect because advanced technology is not exclusive to nurse managers, is important for improving patient care, and is not a waste of time as it helps nurses stay updated with the latest advancements.

2. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

• A. use only the lispro insulin until the symptoms are resolved
• B. limit calorie intake until the glucose is less than 120 mg/dL
• C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
• D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%

Correct answer: C

Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.

3. Which agency reviews whether an organization meets its own criteria for staffing?

• A. American Nurses Association (ANA)
• B. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
• C. Patient Classification Systems (PCSs)
• D. Nursing Care Hours (NCHs)

Correct answer: B

Rationale: The correct answer is the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This agency specifies that the right number of competent staff should be provided to meet client's needs. Choices A, C, and D are incorrect as they do not focus on the review of staffing criteria within an organization. The American Nurses Association (ANA) is an organization that supports nurses, Patient Classification Systems (PCSs) are tools used for patient classification, and Nursing Care Hours (NCHs) are related to the number of care hours provided.

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. Which of the following are considered part of the operating expenses within health care organizations? (EXCEPT)

• A. Maintenance costs
• B. Rental fees
• C. Renovation costs
• D. Supplies

Correct answer: C

Rationale: Operating expenses in health care organizations typically include costs like maintenance, rental fees, and supplies as they are necessary for the day-to-day operations. Renovation costs, on the other hand, are considered capital expenses as they involve significant improvements to facilities rather than routine operational expenses. Therefore, the correct answer is C. Choices A, B, and D are part of operating expenses in health care organizations because they directly contribute to the ongoing operational needs.

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