Nursing Elites

1. In which order will the nurse take these steps to prepare NPH 20 units and regular insulin 2 units using the same syringe? (Put a comma and a space between each answer choice [A, B, C, D, E]).

• A. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
• B. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
• C. Rotate NPH vial, Inject 20 units of air into NPH vial, Inject 2 units of air into regular insulin vial, Withdraw regular insulin, Withdraw 20 units of NPH.
• D. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw 20 units of NPH, Inject 2 units of air into regular insulin vial, Withdraw regular insulin.

Correct answer: C

Rationale: The correct order to prepare NPH 20 units and regular insulin 2 units using the same syringe is to start by rotating the NPH vial, then injecting 20 units of air into the NPH vial. Next, inject 2 units of air into the regular insulin vial, followed by withdrawing the regular insulin. Finally, withdraw 20 units of NPH. This sequence ensures proper mixing and preparation of the insulin doses. Choices A, B, and D have incorrect sequences that may lead to incorrect dosages or inadequate mixing of the insulins.

2. The ANA is a registered labor organization, but it does not engage in direct __________.

• A. Empower union affiliation
• B. Reward union affiliation
• C. Encourage union affiliation
• D. Collective bargaining

Correct answer: D

Rationale: The correct answer is D, 'Collective bargaining.' The American Nurses Association is a registered labor organization, but it does not engage in direct collective bargaining. The actual certification of units, negotiation of contracts, and administration of contracts is conducted by the state nurses associations (SNAs). Choices A, B, and C are incorrect as the ANA's role does not involve empowering, rewarding, or encouraging union affiliation directly.

3. The complexities of the current health care delivery systems require a variety of leadership styles. Which of the following is one that has emerged in response to these changes?

• A. Quantum
• B. Servant
• C. Autocratic
• D. Democratic

Correct answer: A

Rationale: The correct answer is A: Quantum. The quantum theory of leadership addresses complexity in organizations, making it suitable for the challenges posed by the current health care delivery systems. Servant leadership (choice B) focuses on serving others rather than traditional hierarchies, but it is not specifically tailored to address complexities. Autocratic leadership (choice C) and Democratic leadership (choice D) are more traditional styles that may not be as effective in handling the intricacies of modern health care systems.

4. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?

• A. Urine dipstick for glucose
• B. Oral glucose tolerance test
• C. Fasting blood glucose level
• D. Glycosylated hemoglobin level

Correct answer: D

Rationale: The correct answer is D: Glycosylated hemoglobin level. Glycosylated hemoglobin, also known as hemoglobin A1c, provides a long-term indicator of blood glucose control over the past 2-3 months. It is a valuable tool in assessing the effectiveness of diabetes treatment because it reflects average blood sugar levels during this period. Choices A, B, and C are not as effective for evaluating long-term glucose control. Urine dipstick for glucose only provides a snapshot of glucose levels at the time of testing, oral glucose tolerance test evaluates how the body processes glucose after drinking a sugary solution, and fasting blood glucose level gives a point-in-time measurement of glucose levels after fasting, but they do not reflect the overall glucose control over several months.

5. 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.

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