Nursing Elites

1. When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the healthcare provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may

• A. require administration of insulin while taking prednisone
• B. develop acute hypoglycemia while taking prednisone
• C. require administration of insulin while taking prednisone
• D. have rashes caused by metformin-prednisone interactions

Correct answer: C

Rationale: When a patient taking metformin develops an allergic rash from an unknown cause and is prescribed prednisone, the nurse should anticipate that the patient may require administration of insulin while taking prednisone. Prednisone can increase blood glucose levels by antagonizing the effects of insulin, leading to hyperglycemia. Therefore, the patient may need additional insulin to manage blood sugar levels effectively. The other options are incorrect as prednisone would not directly cause a need for a higher-calorie diet, acute hypoglycemia, or rashes caused by a metformin-prednisone interaction.

2. What is the primary goal of a root cause analysis (RCA) in healthcare?

• A. To assign blame for errors
• B. To prevent future errors by identifying underlying causes
• C. To improve patient satisfaction
• D. To analyze the financial impact of errors

Correct answer: B

Rationale: The correct answer is B: 'To prevent future errors by identifying underlying causes.' Root cause analysis (RCA) in healthcare aims to delve deep into the factors contributing to an error to prevent its recurrence. Choice A is incorrect as RCA focuses on identifying system issues, not blaming individuals. Choice C is incorrect as while improving patient satisfaction may result from the process, it is not the primary goal. Choice D is incorrect as the main focus of RCA is not financial analysis but rather improving patient safety.

3. A nurse manager asks the staff to submit written suggestions for a change in policy. The group would then vote on the different suggestions. What type of decision-making technique did the nurse manager use?

• A. Statistical aggregation
• B. Nominal group technique
• C. Brainstorming
• D. Delphi

Correct answer: B

Rationale: The nurse manager used the nominal group technique. This technique involves group members submitting written suggestions, followed by a voting process. Statistical aggregation involves analyzing numerical data, not suggestions. Brainstorming focuses on generating creative ideas collectively, without a structured voting process. Delphi technique involves reaching a consensus through a series of questionnaires or surveys, without a direct voting process.

4. Which of the following is an example of a tertiary prevention activity?

• A. Administering immunizations
• B. Physical therapy for stroke patients
• C. Routine health screenings
• D. Health education campaigns

Correct answer: B

Rationale: The correct answer is B, physical therapy for stroke patients. Tertiary prevention aims to prevent complications and improve the quality of life for individuals who already have a disease or condition. Administering immunizations (choice A) is an example of primary prevention to prevent the onset of diseases. Routine health screenings (choice C) are part of secondary prevention to detect diseases early. Health education campaigns (choice D) typically fall under primary prevention by educating and promoting healthy behaviors to prevent diseases.

5. A healthcare professional is caring for a client who has a sodium level of 125 mEq/L (136 to 145 mEq/L). Which of the following findings should the healthcare professional expect?

• A. Positive Chvostek's sign
• B. Bradycardia
• C. Numbness of the extremities
• D. Abdominal cramping

Correct answer: D

Rationale: A sodium level of 125 mEq/L indicates hyponatremia, which can lead to abdominal cramping. Abdominal cramping is a common symptom of hyponatremia due to an imbalance in electrolytes. While other options like Chvostek's sign, bradycardia, and numbness of the extremities can be associated with other electrolyte imbalances, they are not typically seen with low sodium levels. Chvostek's sign is related to hypocalcemia, bradycardia can be seen in hyperkalemia, and numbness of the extremities can be a symptom of hypocalcemia or hypokalemia, but not directly related to hyponatremia.

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