Nursing Elites

1. What is the primary purpose of clinical pathways in healthcare?

• A. Reduce hospital readmissions
• B. Standardize care
• C. Provide individualized care
• D. Streamline care processes

Correct answer: C

Rationale: The primary purpose of clinical pathways in healthcare is to provide individualized care. While clinical pathways do involve standardizing treatment plans, their main goal is to tailor these plans to the individual needs of patients. This customization ensures that patients receive care that is specific to their condition and requirements, rather than a one-size-fits-all approach. Choices A, B, and D are incorrect because although reducing hospital readmissions, standardizing care, and streamlining care processes can be benefits of clinical pathways, they are not the primary purpose. The main focus is on delivering personalized treatment paths to enhance patient outcomes.

2. An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN�s friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying?

• A. Fidelity
• B. Confidentiality
• C. Veracity
• D. Accountability

Correct answer: B

Rationale: The RN should consider the ethical principle of confidentiality when replying.

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. Which of the following is an example of total time lost?

• A. Number of days off that an employee asks for
• B. Number of scheduled days missed
• C. Number of days missed
• D. Number of days perceived to be absent

Correct answer: B

Rationale: The correct answer is B. Total time lost refers to the number of scheduled days that an employee misses. This includes days that were planned to be worked but were not. Choice A, 'Number of days off that an employee asks for,' is not necessarily time lost as these are approved absences. Choice C, 'Number of days missed,' is vague and does not specify if they are scheduled or unscheduled. Choice D, 'Number of days perceived to be absent,' is subjective and does not clearly relate to scheduled time lost.

5. Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)

• A. Notify the nursing supervisor.
• B. Notify security.
• C. Have them check patients to verify safety.
• D. Ask construction workers to be responsible.

Correct answer: D

Rationale: When construction is ongoing in a healthcare setting, it is essential to address safety concerns promptly. While it is crucial to notify the nursing supervisor and security to manage potential risks, having staff check patients for safety is also a valid precautionary measure. However, asking construction workers to be responsible is not a proper action to address the safety concerns posed by the equipment. Construction workers are professionals responsible for their tasks; it is the healthcare facility's responsibility to ensure patient and staff safety in such situations.

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