Nursing Elites

1. What is the focus of a continuous quality improvement program?

• A. Family
• B. Client
• C. Nurse
• D. Physician

Correct answer: B

Rationale: The correct answer is B: Client. Continuous quality improvement programs are primarily focused on improving services and outcomes for clients or patients. While families, nurses, and physicians are essential in healthcare, in the context of quality improvement, the main focus is on enhancing the experience and results for the clients receiving care. Choices A, C, and D are incorrect because they do not align with the primary goal of a continuous quality improvement program, which is to enhance client satisfaction, safety, and outcomes.

2. The staff on a medical-surgical unit is in conflict with the occupational therapy department. What type of communication will be used to discuss the problems?

• A. Downward communication
• B. Lateral communication
• C. Distorted communication
• D. Upward communication

Correct answer: B

Rationale: The correct answer is B: Lateral communication. Lateral communication occurs between individuals or departments of the same hierarchical level, making it suitable for addressing conflicts between the staff on a medical-surgical unit and the occupational therapy department. Upward communication involves communication from staff to management or from lower management to middle or upper management. Downward communication is typically directive communication from an authority figure or manager to staff. Distorted communication is not a recognized type of communication and does not apply to this scenario.

3. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

4. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

5. According to Maslow's theory, which level of needs must be met first?

• A. Self-actualization needs
• B. Esteem needs
• C. Safety needs
• D. Physiological needs

Correct answer: D

Rationale: According to Maslow's hierarchy of needs, physiological needs are at the lowest level and must be satisfied first before an individual can progress to fulfilling higher-level needs. Physiological needs include basic requirements for survival such as food, water, shelter, and sleep. Esteem needs, safety needs, and self-actualization needs are higher-level needs that can only be addressed once physiological needs are adequately met. Therefore, the correct answer is D, physiological needs.

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