Nursing Elites

1. Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select one that does not apply.

• A. The nurse could have given the insulin subcutaneously.
• B. The nurse did not have to contact the physician.
• C. The nurse should have used regular insulin (Humulin R).
• D. The nurse used the correct insulin.

Correct answer: C

Rationale: The best evaluation of the nurse reveals that she should have used regular insulin (Humulin R) for IV administration. Regular insulin is the only insulin approved for intravenous administration due to its pharmacokinetic properties. Insulin lispro (Humalog) is not suitable for IV use. Choice A is incorrect because giving insulin intravenously is necessary in this case of high blood sugar. Choice B is incorrect because administering a different insulin without consulting the physician is not appropriate. Choice D is incorrect because the nurse used the incorrect insulin, which could pose risks to the client's health.

2. Which technique or method is used to determine whether or not the patient has an irregular pulse?

• A. Apical pulse
• B. Inspection
• C. Auscultation
• D. Percussion

Correct answer: A

Rationale: An apical pulse check is used to determine if the patient has an irregular pulse. The apical pulse is located at the point of maximal impulse (PMI) and is assessed using a stethoscope. Choice B, inspection, involves visual examination and is not used to assess pulse irregularities. Choice C, auscultation, involves listening to internal sounds using a stethoscope, which can be used to assess heart sounds but not specifically for pulse irregularities. Choice D, percussion, is a technique used to assess the density of body tissues or detect abnormal masses and is not used to determine pulse irregularities.

3. Which of the following strategies can help improve patient adherence to treatment plans?

• A. Providing clear and understandable instructions
• B. Using medical jargon
• C. Limiting patient education
• D. Ignoring patient feedback

Correct answer: A

Rationale: Providing clear and understandable instructions can help improve patient adherence to treatment plans. Clear instructions help patients better understand their treatment plans, leading to increased compliance. Choices B, C, and D are incorrect. Using medical jargon can confuse patients and reduce adherence. Limiting patient education deprives patients of essential information needed for adherence. Ignoring patient feedback can lead to misunderstandings and hinder the patient's commitment to the treatment plan.

4. You are working on a pediatric unit. Which toy or other diversional item or activity is most appropriate for your 18-month-old patient?

• A. Story books
• B. Beach balls
• C. An interactive play session with other children less than 2 years of age
• D. Pickup sticks

Correct answer: B

Rationale: A beach ball is appropriate for an 18-month-old as it is safe and can help with motor skills development. Choice A, storybooks, may not be suitable for this age group due to limited attention span. Choice C involves interaction with other children which may not always be feasible in a healthcare setting. Choice D, pickup sticks, poses a choking hazard and is not suitable for toddlers.

5. Select the type of skeletal fracture that is correctly paired with its description.

• A. A complete fracture: The fractured bone penetrates through the skin to the skin surface.
• B. A pathological fracture: A fracture that results from some physical trauma.
• C. A greenstick fracture: This bends but does not fracture the bone.
• D. An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament

Correct answer: D

Rationale: The correct answer is D. An avulsion fracture occurs when a part of the bone is pulled away by a tendon or ligament. Choice A is incorrect because it describes an open fracture where the bone penetrates the skin. Choice B is incorrect as a pathological fracture results from an underlying disease weakening the bone, not physical trauma. Choice C is incorrect as a greenstick fracture involves the bone bending but not completely breaking.

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