Nursing Elites

1. Which of the following best describes the concept of evidence-based management?

• A. Using personal experience to make managerial decisions
• B. Combining managerial expertise with the latest research evidence
• C. Using intuition and experience to guide management decisions
• D. Relying on peer-reviewed literature to inform management practices

Correct answer: B

Rationale: The concept of evidence-based management involves combining managerial expertise with the latest research evidence to make informed decisions. Choice A is incorrect because relying solely on personal experience may not align with the best available evidence. Choice C is incorrect as it emphasizes intuition over research evidence. Choice D is incorrect because evidence-based management involves not only peer-reviewed literature but also incorporating managerial expertise.

2. Which of the following is an example of a secondary prevention activity?

• A. Blood pressure screening
• B. Administering medications
• C. Developing a care plan
• D. Providing rehabilitation

Correct answer: A

Rationale: The correct answer is A, blood pressure screening. Secondary prevention aims to identify and treat conditions early to prevent their progression. Blood pressure screening helps in early detection of hypertension, allowing for timely intervention. Choices B, C, and D are not examples of secondary prevention activities. Administering medications (B) can be part of treatment after a condition is diagnosed, developing a care plan (C) is more related to organizing and coordinating care rather than prevention, and providing rehabilitation (D) focuses on recovery and improvement post-diagnosis rather than early detection and prevention.

3. What term refers to the situation where the pay of newer employees is similar to or higher than that of more experienced employees?

• A. Salary compression
• B. Salary expectations
• C. Salary range
• D. Salary inflation

Correct answer: A

Rationale: Salary compression is the term used to describe the situation where the pay of newer employees is similar to or higher than that of more experienced employees. This can happen when newer employees are paid higher salaries to attract them, leading to a compressed salary structure in the organization. Choice B, 'Salary expectations,' does not specifically refer to the scenario described in the question. Choice C, 'Salary range,' is a broader term referring to the range of salaries offered for a particular job or position, not specifically related to the disparity between new and experienced employees. Choice D, 'Salary inflation,' does not accurately describe the situation of newer employees earning higher salaries than more experienced ones; instead, it refers to a general increase in wages across the board.

4. During a physical assessment of adult clients, which of the following techniques should the nurse use?

• A. Use the Face, Legs, Activity, Cry, and Consolability (FLACC) pain rating scale for a client experiencing pain.
• B. Palpate the client's abdomen before auscultating bowel sounds.
• C. Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.
• D. Obtain an apical heart rate by auscultating at the third intercostal space to the left of the sternum.

Correct answer: B

Rationale: When performing a physical assessment, it is essential to palpate the client's abdomen before auscultating bowel sounds. This sequence helps prevent altering bowel sound results due to the pressure applied during palpation. Choice A is incorrect because the FLACC pain rating scale is typically used for nonverbal or pediatric clients, not adults. Choice C is incorrect because the bladder of the blood pressure cuff should surround about 80% of the client's arm circumference, not the bladder of the cuff itself. Choice D is incorrect because to obtain an apical heart rate, auscultation should be done at the fifth intercostal space at the midclavicular line, not at the third intercostal space to the left of the sternum.

5. 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.

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