Nursing Elites

1. What is the primary reason for conducting a performance appraisal?

• A. Providing constructive feedback.
• B. Imposing punishment.
• C. Identifying issues.
• D. Offering coaching.

Correct answer: A

Rationale: The primary reason for conducting a performance appraisal is to provide constructive feedback to employees. This feedback helps employees understand what is expected of them, how well they are performing, and areas where they can improve. Choice B (Imposing punishment) is incorrect because performance appraisals should focus on development rather than punishment. Choice C (Identifying issues) is not the primary reason but can be a secondary outcome of performance appraisals. Choice D (Offering coaching) is related to providing guidance and support, which is a part of the feedback process but not the primary reason for conducting a performance appraisal.

2. How are values learned?

• A. Reading books
• B. Formal degrees
• C. Continuous reinforcement
• D. Meeting diverse individuals

Correct answer: C

Rationale: Values are learned through continuous reinforcement, where behaviors or beliefs are strengthened by consequences or rewards. Reading books (choice A) may expose individuals to different perspectives and values, but the active learning and internalization of values typically occur through reinforcement. Formal degrees (choice B) may provide education and knowledge, but values are more likely to be ingrained through continuous reinforcement. Meeting diverse individuals (choice D) can also influence values, but the consistent reinforcement of desired behaviors is a more direct method for learning values.

3. A 27-year-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium level of 3.1 mEq/L. Which action prescribed by the healthcare provider should the nurse take first?

• A. Place the patient on a cardiac monitor
• B. Administer IV potassium supplements
• C. Obtain urine glucose and ketone levels
• D. Start an insulin infusion at 0.1 units/kg/hr

Correct answer: Place the patient on a cardiac monitor

Rationale: In a patient with diabetic ketoacidosis (DKA), the initial priority is to assess for any cardiac arrhythmias due to electrolyte imbalances. Since the patient has a low serum potassium level of 3.1 mEq/L, placing the patient on a cardiac monitor is crucial to monitor for any potential cardiac complications. Administering IV potassium supplements (Choice B) may be needed, but it is not the first action to take. Obtaining urine glucose and ketone levels (Choice C) and starting an insulin infusion (Choice D) are important interventions in managing DKA, but ensuring patient safety by monitoring for arrhythmias takes precedence.

4. When communicating with a client who has a complaint, what principle is important to keep in mind?

• A. Supervisors should always be involved.
• B. The client's physician is often the cause of the problem.
• C. Avoid discussion of complaints.
• D. Clients and families should be treated with respect; communication should be open and honest.

Correct answer: D

Rationale: When addressing complaints from clients, it is crucial to prioritize treating clients and families with respect. Open and honest communication fosters trust and transparency in resolving issues effectively. This client-centered approach emphasizes the importance of maintaining positive relationships within the healthcare setting. Choices A, B, and C are incorrect. Involving supervisors in every communication with a client who has a complaint may not always be necessary or practical. Blaming the client's physician for the issue is unprofessional and does not address the client's concerns. Avoiding discussion of complaints can lead to unresolved issues and dissatisfaction among clients.

5. Which statement by the patient indicates a need for additional instruction in administering insulin?

• A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
• B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
• C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
• D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'

Correct answer: A

Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.

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