Nursing Elites

1. Several factors are considered in the calculation of the amount of FTEs. Which of the following is NOT considered when calculating the FTEs?

• A. Hours of care provided
• B. Ancillary staff
• C. Procedures to be done
• D. Types of patients

Correct answer: A

Rationale: When calculating Full-Time Equivalents (FTEs), factors such as the hours of work for the staff for two weeks, average daily census, and types of patients are considered. However, the hours of care provided are not typically included in the calculation of FTEs. Therefore, the correct answer is A. Choice B, ancillary staff, can impact FTE calculations as they contribute to the overall workload. Choice C, procedures to be done, can also influence FTE calculations, especially if they affect staffing requirements. Choice D, types of patients, play a role in determining the level of care needed and subsequently impact FTE calculations.

2. Factors that may contribute to workplace violence in a health care setting include:

• A. Lack of armed security
• B. Continuous loud noises and/or poorly monitored entrances
• C. Poor staff interactions
• D. Tense shoulders and clenched fists

Correct answer: B

Rationale: The correct answer is B. Continuous loud noises and poorly monitored entrances can contribute to workplace violence by creating a chaotic environment that can escalate tensions. Factors like lack of armed security (choice A) may not be as significant in triggering violence as environmental factors. Poor staff interactions (choice C) can contribute to a negative work culture but may not directly lead to violence. Tense shoulders and clenched fists (choice D) may indicate stress or anger in an individual but are not factors that contribute to workplace violence in general.

3. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
• B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
• C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
• D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

4. 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: A

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.

5. What is the main purpose of a clinical audit?

• A. To measure patient satisfaction
• B. To evaluate the effectiveness of clinical practices
• C. To identify areas for improvement
• D. To standardize patient care protocols

Correct answer: C

Rationale: The main purpose of a clinical audit is to identify areas for improvement in clinical practices. While patient satisfaction might be a component evaluated during an audit, the primary goal is to ensure that care is safe, effective, and patient-centered, rather than solely focusing on satisfaction. Evaluating the effectiveness of clinical practices is a related but more specific goal compared to the broader aim of identifying areas for improvement. Standardizing patient care protocols can be a result of a clinical audit, but it is not the main purpose, which is to pinpoint areas needing enhancement.

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