Nursing Elites

1. Which of the following best describes the concept of holistic nursing?

• A. An approach that integrates the mind, body, and spirit in patient care
• B. A method that focuses solely on physical health
• C. A practice that considers only the patient's physical condition
• D. A framework for improving hospital administration

Correct answer: A

Rationale: The correct answer is A: 'An approach that integrates the mind, body, and spirit in patient care.' Holistic nursing is a comprehensive approach that considers the whole person, including their physical, emotional, social, and spiritual well-being. Choice B is incorrect because holistic nursing goes beyond just physical health. Choice C is incorrect because holistic nursing considers various aspects of the patient, not just the physical condition. Choice D is incorrect because holistic nursing is focused on patient care and well-being, not hospital administration.

2. After change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

3. Which of the following are important techniques when giving directions to subordinates? (EXCEPT)

• A. Know the context of the instructions.
• B. Use lateral communication.
• C. Verify feedback.
• D. Get positive attention.

Correct answer: B

Rationale: The correct answer is B: 'Use lateral communication.' When giving directions to subordinates, it is important to know the context of the instructions, get positive attention, verify feedback, and give follow-up communication. Lateral communication refers to communication between individuals or groups on the same organizational level, which is not directly related to giving directions to subordinates. Choices A, C, and D are important techniques that help ensure effective communication with subordinates.

4. What is the main purpose of a utilization review?

• A. Evaluate patient outcomes
• B. Ensure compliance with regulations
• C. Reduce hospital readmissions
• D. Assess financial impact

Correct answer: A

Rationale: The main purpose of a utilization review is to evaluate patient outcomes and ensure that patients receive appropriate care based on medical necessity and quality standards. While ensuring compliance with regulations, reducing hospital readmissions, and assessing financial impact are important aspects of healthcare management, the primary goal of utilization review is to focus on the quality and effectiveness of patient care.

5. 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.

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