Nursing Elites

1. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
• B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
• C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
• D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

2. 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.

3. A nurse manager is using the nominal group technique to gather input from the staff on a new policy. What is the primary method of exchange in this technique?

• A. Oral presentations
• B. Email exchanges
• C. Written reports
• D. Group discussions

Correct answer: C

Rationale: In the nominal group technique, the primary method of exchange is through written reports. Participants independently generate ideas in writing, which are then shared and discussed within the group. This structured process allows for equal participation and prevents dominant individuals from influencing the group's outcome. Oral presentations (choice A) involve speaking rather than written communication, making it less suitable for the nominal group technique. Email exchanges (choice B) are also not the primary method as they lack the structured approach of the nominal group technique. Group discussions (choice D) do occur in the nominal group technique but are secondary to the initial written idea generation phase.

4. What is the primary responsibility of a nurse manager in a healthcare setting?

• A. To provide direct patient care
• B. To manage healthcare facilities
• C. To oversee administrative tasks
• D. To conduct clinical research

Correct answer: C

Rationale: The correct answer is C: 'To oversee administrative tasks.' Nurse managers in healthcare settings are primarily responsible for managing the administrative aspects of a unit, ensuring smooth operations and efficiency. Choice A is incorrect because providing direct patient care is usually the responsibility of staff nurses, not nurse managers. Choice B is incorrect as managing healthcare facilities involves a broader scope of responsibilities beyond the role of a nurse manager. Choice D is also incorrect as conducting clinical research is typically not a primary responsibility of a nurse manager in a healthcare setting.

5. A client is discussing the use of herbal supplements for health promotion with a nurse. Which of the following client statements indicates an understanding of herbal supplement use?

• A. I can take echinacea to improve my immune system.
• B. I can take feverfew to reduce my level of anxiety.
• C. I can take ginger to improve my memory.
• D. I can take ginkgo biloba to relieve nausea.

Correct answer: D

Rationale: The correct answer is D. Ginkgo biloba is commonly used to improve blood circulation and relieve symptoms of cognitive disorders like dementia. The other choices are incorrect because echinacea is used to boost the immune system, feverfew is used for migraines and headaches, and ginger is known for its anti-inflammatory properties and aiding digestion, not memory improvement.

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