Nursing Elites

1. What is the purpose of a healthcare audit?

• A. To increase paperwork
• B. To assess and improve quality of care
• C. To reduce patient satisfaction
• D. To limit healthcare services

Correct answer: B

Rationale: The correct answer is B: 'To assess and improve quality of care.' Healthcare audits are conducted to evaluate the quality and efficiency of healthcare services provided. Choice A, 'To increase paperwork,' is incorrect as audits aim to streamline processes and reduce unnecessary paperwork. Choice C, 'To reduce patient satisfaction,' is incorrect as audits are meant to identify areas for improvement to enhance patient satisfaction. Choice D, 'To limit healthcare services,' is also incorrect as audits help in optimizing healthcare services rather than limiting them.

2. What percentage of term newborns have a congenital heart disease due to environmental risk factors such as maternal alcoholism or drug ingestion?

• A. 2% to 4%
• B. 10% to 20%
• C. 5% to 10%
• D. 7% to 9%

Correct answer: A

Rationale: The correct answer is A: 2% to 4%. According to research, 2% to 4% of term newborns have congenital heart disease due to environmental risk factors such as maternal alcoholism or drug ingestion. Choices B, C, and D provide percentages that are higher than the actual prevalence of congenital heart disease in newborns caused by environmental factors, making them incorrect.

3. In which position will you place your patient when they are demonstrating the signs and symptoms of hypovolemic shock?

• A. The Trendelenburg position
• B. The supine position
• C. The left lateral position
• D. The right lateral position

Correct answer: A

Rationale: The correct answer is A, the Trendelenburg position. This position involves placing the patient with their legs elevated higher than their head. It is used to increase blood flow to the upper body, including the brain and heart, in cases of hypovolemic shock. This helps improve perfusion to vital organs. Choices B, C, and D are incorrect as they do not facilitate the desired redistribution of blood flow needed in hypovolemic shock. The supine position is lying flat on the back, the left lateral position is lying on the left side, and the right lateral position is lying on the right side.

4. Which of the following changes was enacted by the Patient Protection and Affordable Care Act?

• A. Creation of national health insurance exchanges for affordable insurance coverage
• B. Expansion of school-based health centers
• C. Free preventative services for all
• D. Medically managed clinics eligible for federal funding

Correct answer: B

Rationale: The correct answer is B. The Patient Protection and Affordable Care Act expanded school-based health centers to provide additional healthcare services to students. Choice A is incorrect because the creation of national health insurance exchanges was a key provision of the Affordable Care Act, but it was not the only change enacted by the legislation. Choice C is incorrect as while the Affordable Care Act did include provisions for free preventative services for certain groups, it was not applicable to all individuals. Choice D is incorrect as the Act did not specifically address medically managed clinics eligible for federal funding.

5. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should:

• A. Call the physician
• B. Encourage the intake of fluids
• C. Administer the insulin as ordered
• D. Give the client ½ cup of orange juice

Correct answer: C

Rationale: In this scenario, the client with type 1 DM has a high glucose level at bedtime. The appropriate action for the nurse is to administer the sliding scale insulin as ordered. This insulin regimen is specifically designed to manage high blood glucose levels. Calling the physician is not necessary as the protocol for sliding scale insulin is already in place. Encouraging fluid intake or providing orange juice is not the correct intervention for addressing high blood glucose levels in this case.

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