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. 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.

3. Which of the following best describes the purpose of a root cause analysis (RCA)?

• A. Identify the person responsible for an error
• B. Determine who should be disciplined
• C. Discover the underlying causes of an error
• D. Evaluate the effectiveness of a new policy

Correct answer: C

Rationale: The correct answer is C: 'Discover the underlying causes of an error.' Root cause analysis (RCA) focuses on identifying the fundamental reason(s) that led to an error or problem rather than placing blame on individuals. Choice A and B are incorrect as RCA is not about pinpointing a specific person to blame or determining disciplinary actions. Choice D is also incorrect as the primary goal of RCA is not to evaluate policy effectiveness but to uncover the root causes of issues for effective problem-solving.

4. When utilizing an internal float pool, which of the following pools is most efficient?

• A. Centralized
• B. Flexible
• C. Mixed
• D. Decentralized

Correct answer: A

Rationale: Centralization is the most efficient option when utilizing an internal float pool because it allows for a pool of nurses to be used anywhere in the hospital. In centralized pools, staff members are not limited to working for only one nurse manager or on only one unit, unlike in decentralized pools. Flexible and mixed pools may offer some advantages, but in terms of efficiency and utilization of resources, centralized pools are the most effective choice.

5. When considering virtue ethics, which of the following is true?

• A. Virtue ethics attributes behaviors to moral rules.
• B. Virtue ethics attributes behaviors to knowledge of consequences.
• C. Virtue ethics focuses on moral character, rather than rules for behavior.
• D. Virtue ethics is a formal statement of rules for behavior.

Correct answer: C

Rationale: The correct answer is C: Virtue ethics focuses on qualities and moral character rather than rules or duties. Virtue ethics emphasizes developing good character traits, such as courage, honesty, and compassion, to guide behavior rather than adhering to specific moral rules or focusing on the consequences of actions. Choices A, B, and D are incorrect because virtue ethics does not attribute behaviors to moral rules, knowledge of consequences, or formal statements of rules for behavior; instead, it emphasizes the importance of cultivating virtuous character.

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