Nursing Elites

1. What is the primary focus of the Institute for Healthcare Improvement (IHI)?

• A. Patient safety
• B. Cost reduction
• C. Healthcare innovation
• D. Research funding

Correct answer: A

Rationale: The primary focus of the Institute for Healthcare Improvement (IHI) is patient safety. IHI is renowned for its efforts in developing and implementing evidence-based practices to enhance patient safety and improve the quality of care in healthcare settings. While cost reduction, healthcare innovation, and research funding are important aspects of healthcare, the core mission of the IHI revolves around prioritizing patient safety. Patient safety involves reducing medical errors, improving care processes, and creating a safer environment for patients, which are all fundamental to the work of the IHI.

2. A nurse is caring for a client who is scheduled to be transferred to a long-term care facility. The client's family questions the nurse about the reasons for the transfer. Which of the following responses made by the nurse is appropriate?

• A. The transfer of your family member is being done because the provider knows what's best.
• B. Would you like us to discuss the transfer with your family member?
• C. Why are you so concerned about this transfer?
• D. I know how you feel. My parent had to be transferred to a long-term care facility.

Correct answer: A

Rationale: The correct response is A because it provides a professional and reassuring explanation for the transfer, focusing on the expertise of the healthcare provider. Choice B offers to include the family member in the discussion, which may not address their concerns directly. Choice C appears defensive and does not address the family's inquiry. Choice D shifts the focus to the nurse's personal experience, which may not be relevant or helpful to the family seeking information about their own situation.

3. The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which patient statement indicates a need for additional teaching?

• A. “If I overeat at a meal, I will still take the usual dose of medication.”
• B. “Other medications besides the Glucotrol may affect my blood sugar.”
• C. “When I am ill, I may have to take insulin to control my blood sugar.”
• D. “My diabetes won’t cause complications because I don’t need insulin.”

Correct answer: D

Rationale:

4. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

5. Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)?

• A. The patient’s blood glucose level is 174 mg/dL.
• B. The patient has gained 2 lb (0.9 kg) since yesterday.
• C. The patient is scheduled for a chest x-ray in an hour
• D. The patient’s blood urea nitrogen (BUN) level is 52 mg/dL.

Correct answer: D

Rationale:

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