Nursing Elites

1. What are the key elements essential to the implementation of case management? (Select all that apply.)

• A. Collaborative practice teams
• B. Established critical pathways
• C. Quality management system
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Established critical pathways, collaborative practice teams, and quality management systems are indeed key elements essential to the implementation of case management. Collaborative practice teams allow for multidisciplinary collaboration, established critical pathways help guide patient care, and a quality management system ensures that care provided meets established standards. Choice A, collaborative practice teams, is correct as they are fundamental for effective case management, involving various professionals working together. Choice B, established critical pathways, is also correct as they provide a structured approach to managing patient care. Choice C, quality management system, is correct as it ensures that care is delivered at high standards and continuously monitored for improvement. Therefore, all these elements are crucial for successful case management implementation.

2. When addressing a policy violation, what is one of the initial steps to take?

• A. Terminate the employee.
• B. Confront the employee.
• C. Discipline the employee immediately.
• D. Determine whether the employee is aware of the policy.

Correct answer: D

Rationale: When addressing a policy violation, one of the initial steps should be to determine whether the employee is aware of the policy. This step allows for clarification, feedback, and potential training if needed. Terminating the employee (Choice A) or disciplining immediately (Choice C) without assessing awareness can lead to unfair treatment and legal issues. Confronting the employee (Choice B) may be necessary but should come after establishing awareness and providing necessary support or education.

3. 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.

4. Which of the following best describes the role of a nurse navigator?

• A. Provide direct patient care
• B. Coordinate complex care
• C. Assist with administrative tasks
• D. Manage clinical trials

Correct answer: B

Rationale: A nurse navigator's primary role is to coordinate complex care for patients, guiding them through the healthcare system. Choice A is incorrect because nurse navigators do not provide direct patient care like nurses in clinical settings. Choice C is incorrect as nurse navigators focus on patient care coordination rather than administrative tasks. Choice D is incorrect as managing clinical trials is typically not within the scope of a nurse navigator's responsibilities.

5. A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?

• A. Infuse dextrose 50% by slow IV push.
• B. Administer 1 mg glucagon subcutaneously.
• C. Obtain a glucose reading using a finger stick.
• D. Have the patient drink 4 ounces of orange juice.

Correct answer: C

Rationale: The correct action for the nurse to take first when a patient reports feeling lightheaded and sweaty after being weaned off an insulin drip is to obtain a glucose reading using a finger stick. This will provide crucial information on the patient's current blood glucose level, helping the nurse assess if the symptoms are due to hypoglycemia. Based on the glucose reading, appropriate interventions can be initiated, such as administering dextrose, glucagon, or oral sugars like orange juice if hypoglycemia is confirmed. However, verifying the blood glucose level is the initial step to guide subsequent actions and ensure patient safety.

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