Nursing Elites

1. After examining her client's abdomen and noting assessment of significant findings, even though the client says it doesn't hurt, the nurse says to a colleague, 'I think something is going on here; I am going to investigate further.' This nurse is using:

• A. Deductive reasoning.
• B. Intuition.
• C. Trial and error.
• D. Modified scientific method.

Correct answer: B

Rationale: The correct answer is B: Intuition. In this scenario, the nurse is relying on intuition, which refers to a 'gut feeling' or instinctive understanding without the conscious use of reasoning. Deductive reasoning (choice A) involves drawing specific conclusions from general principles. Trial and error (choice C) is a problem-solving method that involves trying various methods until the correct one is found. The modified scientific method (choice D) refers to a structured approach to conducting experiments in a scientific setting, which is not applicable in this situation where the nurse is relying on a hunch or intuition.

2. What is the main goal of a nursing quality improvement (QI) program?

• A. To enhance patient safety
• B. To reduce healthcare costs
• C. To ensure regulatory compliance
• D. To maintain high patient satisfaction

Correct answer: A

Rationale: The main goal of a nursing quality improvement (QI) program is to enhance patient safety. While reducing healthcare costs, ensuring regulatory compliance, and maintaining high patient satisfaction are important aspects of healthcare delivery, the primary focus of a QI program in nursing is to improve patient safety through practices such as error reduction, risk management, and enhancing the quality of care provided.

3. Which of the following is an example of total time lost?

• A. Number of days off that an employee asks for
• B. Number of scheduled days missed
• C. Number of days missed
• D. Number of days perceived to be absent

Correct answer: B

Rationale: The correct answer is B. Total time lost refers to the number of scheduled days that an employee misses. This includes days that were planned to be worked but were not. Choice A, 'Number of days off that an employee asks for,' is not necessarily time lost as these are approved absences. Choice C, 'Number of days missed,' is vague and does not specify if they are scheduled or unscheduled. Choice D, 'Number of days perceived to be absent,' is subjective and does not clearly relate to scheduled time lost.

4. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

5. The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia) through a restricted access medication program. What is most important for the nurse to report immediately to the health care provider?

• A. The patient's blood pressure is 154/92.
• B. The patient has a history of emphysema
• C. The patient's blood glucose is 86 mg/dL.
• D. The patient has chest pressure when walking

Correct answer: D

Rationale: Chest pressure while walking may indicate heart-related issues such as angina or a heart attack. Rosiglitazone (Avandia) has been associated with increased risks of cardiovascular events like heart failure. Given these risks, chest pressure is an urgent symptom that must be reported immediately to prevent potentially life-threatening complications.

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