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 has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?

• A. The client reports relief of nausea.
• B. The tube aspirate has a pH less than 5.
• C. Bowel sounds are present on auscultation.
• D. An x-ray shows the end of the tube above the pylorus.

Correct answer: A

Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.

3. Which of the following are NOT outcomes of a job analysis? (EXCEPT)

• A. Job specification
• B. Job evaluation
• C. Job description
• D. Job performance

Correct answer: C

Rationale: The correct answer is C. Job description is actually one of the key outcomes of a job analysis. A job description details the duties, responsibilities, and requirements of a specific job role. Job specification, job evaluation, and job performance are not outcomes of a job analysis. Job specification refers to the specific qualifications and skills required for a job, job evaluation involves determining the relative worth of different jobs within an organization, and job performance relates to how well an employee is executing their job duties.

4. Which of the following is a common characteristic of a high reliability organization (HRO)?

• A. Flexibility
• B. Reluctance to simplify
• C. Preoccupation with failure
• D. Deference to expertise

Correct answer: C

Rationale: A common characteristic of a high reliability organization (HRO) is a preoccupation with failure. HROs focus on identifying and addressing potential failure points to prevent errors and maintain high levels of safety and reliability. This mindset helps them anticipate and mitigate risks proactively, leading to better outcomes and performance. Choices A, B, and D are incorrect. While flexibility, reluctance to simplify, and deference to expertise may be important in various contexts, they are not the primary defining characteristics of a high reliability organization. The core focus of HROs is on continuously monitoring for potential failures and working to prevent them.

5. Which of the following best describes the role of a nurse advocate?

• A. Direct patient care provider
• B. Advocate for patient needs
• C. Manage nursing staff
• D. Ensure policy adherence

Correct answer: B

Rationale: The correct answer is B: 'Advocate for patient needs.' A nurse advocate's primary role is to stand up for the patient's rights and ensure their needs are met. Choice A, 'Direct patient care provider,' is incorrect as while nurses do provide direct patient care, the specific role of a nurse advocate goes beyond that. Choice C, 'Manage nursing staff,' is incorrect as this pertains to a nurse manager's role, not a nurse advocate. Choice D, 'Ensure policy adherence,' is also incorrect as this reflects more of a quality assurance or compliance role, rather than the advocacy role of a nurse advocate.

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