Nursing Elites

1. What is the main focus of a risk management program in healthcare?

• A. To reduce hospital readmissions
• B. To manage financial resources
• C. To ensure compliance with healthcare regulations
• D. To improve clinical outcomes

Correct answer: D

Rationale: The main focus of a risk management program in healthcare is to improve clinical outcomes. By identifying and mitigating risks, healthcare organizations aim to enhance patient safety, quality of care, and overall health outcomes. Option A is incorrect because reducing hospital readmissions is a specific goal within healthcare but not the primary focus of risk management. Option B is incorrect as managing financial resources, while important, is more aligned with financial management rather than risk management. Option C is incorrect as ensuring compliance with healthcare regulations is vital but falls under compliance management rather than the primary focus of risk management, which is to improve clinical outcomes.

2. 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.

3. A client experiences difficulty breathing after the change of shift. The nurse on duty discovers that the IVFs were infusing at a rate 10 times the calculated normal. After notifying the physician and correcting the rate, what should be the next step in the client's care?

• A. Notify family
• B. Discipline the previous nurse
• C. Complete an incident report
• D. Obtain legal consultation

Correct answer: C

Rationale: The correct next step in the client's care after notifying the physician and correcting the rate of IVFs is to complete an incident report. This report is essential for documenting the adverse event, analyzing the cause, and implementing preventive measures to avoid similar incidents in the future. Notifying the family, disciplining the previous nurse, and obtaining legal consultation are not immediate priorities in this situation. Family notification may follow the incident report, disciplining the previous nurse is a separate administrative process, and legal consultation is usually not required for a medical error corrected promptly.

4. Successful professional nurses benefit from working with mentors. What mutually rewarding outcomes are realized in mentoring relationships? (EXCEPT)

• A. Instilling a sense of accomplishing a meaningful effort
• B. Assuming each other's characteristics
• C. Fostering an interdependent relationship
• D. Promoting self-esteem

Correct answer: B

Rationale: Professional nurses who seek mentoring relationships work with their mentors to gain objective feedback, guidance, and confidence. A mentoring relationship is critical when making job decisions, establishing goals, discussing professional judgment, considering ethical issues, and in determining challenges for growth. Choice B, "Assuming each other's characteristics," is incorrect because mentoring is about learning, guidance, and support to develop one's own professional identity, not about assuming someone else's characteristics. Choices A, C, and D are all beneficial outcomes of mentoring relationships, including instilling a sense of accomplishment, fostering interdependence, and promoting self-esteem, respectively.

5. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?

• A. Hemoglobin A1C level is 7.9%.
• B. Last eye exam was 18 months ago.
• C. Glomerular filtration rate is decreased.
• D. Patient has questions about the prescribed diet.

Correct answer: C

Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.

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