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. Which of the following is an example of a primary prevention strategy?

• A. Administering vaccinations
• B. Performing a surgical procedure
• C. Teaching healthy lifestyle choices
• D. Prescribing medication

Correct answer: A

Rationale: Administering vaccinations is indeed an example of a primary prevention strategy. Primary prevention aims to prevent the occurrence of a disease or injury before it occurs by targeting the entire population or specific high-risk groups. Vaccinations help prevent the initial development of a disease by enhancing immunity against specific pathogens. Choices B, C, and D are not examples of primary prevention strategies. Performing a surgical procedure (Choice B) is a treatment intervention, not a preventive measure. Teaching healthy lifestyle choices (Choice C) falls under health promotion and education, which is more aligned with secondary prevention. Prescribing medication (Choice D) is typically associated with treatment rather than preventing the initial onset of a disease.

3. Achieving Magnet Hospital designation offers hospitals the following advantages: (Select all that apply.)

• A. Greater client satisfaction.
• B. Improved nursing recruitment.
• C. Greater client workload.
• D. Nurses who are independent decision makers.

Correct answer: C

Rationale: Achieving Magnet Hospital designation offers hospitals advantages such as improved nursing recruitment and greater nursing retention. The empowered, independent problem-solving nurses resulting from this designation contribute to greater client satisfaction and improved nursing care. Therefore, the correct answer is 'Greater client workload' (C). Choices A, B, and D are incorrect because although they are beneficial outcomes of achieving Magnet Hospital designation, they are not advantages specifically mentioned in the provided rationale.

4. An RN enters a patient�s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?

• A. The RN tells the client he is not allowed to leave until the physician has released him.
• B. The RN asks the client why he wishes to leave.
• C. The RN asks the client to explain what he understands about his medical diagnosis.
• D. The RN asks the client to sign an against medical advice discharge form.

Correct answer: A

Rationale: Verbal or physical detainment of a client who desires to leave the institution is false imprisonment.

5. Which of the following statements about time management is true?

• A. Time management is not important in nursing
• B. Writing goals will increase stress
• C. Effective time management reduces stress
• D. Setting goals is a time waster

Correct answer: C

Rationale: The correct answer is C: Effective time management reduces stress. Proper time management allows nurses to prioritize tasks, allocate sufficient time for each activity, and reduce the feeling of being overwhelmed. This, in turn, helps in reducing stress levels and increasing productivity. Choices A, B, and D are incorrect. Time management is crucial in nursing to ensure efficient patient care and task completion. Writing goals helps in providing direction and motivation, reducing stress rather than increasing it. Setting goals is not a time waster; it is a fundamental aspect of effective time management.

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