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. 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. 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.

4. Selecting a person/unit to negotiate on the group's behalf is known as:

• A. Labor negotiations.
• B. Bargaining.
• C. Establishing a union.
• D. Representation election.

Correct answer: D

Rationale: The correct answer is D, representation election. Representation election is the process where individuals within a group vote to select a person or unit to represent and negotiate on their behalf. Options A and B are incorrect because they refer to the broader concepts of labor negotiations and bargaining, not specifically the process of selecting a representative. Option C, establishing a union, is also incorrect as it refers to the formation of a labor union rather than the act of choosing a representative for bargaining.

5. A client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?

• A. Continuous quality improvement
• B. Total quality management
• C. Six Sigma
• D. Quality management

Correct answer: B

Rationale: Total Quality Management (TQM) emphasizes meeting customer needs and satisfaction. In this scenario, by honoring the client's request to delay care to allow for rest, the nurse is aligning with the customer-focused approach of TQM. TQM seeks to continuously improve processes and services to enhance customer experiences and outcomes. Continuous Quality Improvement focuses on incremental improvements in processes and outcomes over time. Six Sigma is a data-driven approach to process improvement that aims to reduce defects and errors. Quality Management is a broader concept that encompasses various strategies to ensure quality standards are met.

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