Nursing Elites

1. Which of the following best describes the purpose of a root cause analysis (RCA)?

• A. Identify the person responsible for an error
• B. Determine who should be disciplined
• C. Discover the underlying causes of an error
• D. Evaluate the effectiveness of a new policy

Correct answer: C

Rationale: The correct answer is C: 'Discover the underlying causes of an error.' Root cause analysis (RCA) focuses on identifying the fundamental reason(s) that led to an error or problem rather than placing blame on individuals. Choice A and B are incorrect as RCA is not about pinpointing a specific person to blame or determining disciplinary actions. Choice D is also incorrect as the primary goal of RCA is not to evaluate policy effectiveness but to uncover the root causes of issues for effective problem-solving.

2. What is the main purpose of a patient satisfaction survey?

• A. To improve patient outcomes
• B. To evaluate nursing performance
• C. To measure patient satisfaction
• D. To assess healthcare facilities

Correct answer: C

Rationale: The main purpose of a patient satisfaction survey is to measure patient satisfaction. These surveys aim to gather feedback directly from patients regarding their experiences and perceptions of the healthcare services they have received. While patient satisfaction may impact outcomes indirectly, the primary goal of the survey is not to directly improve patient outcomes, making choice A incorrect. Choice B is incorrect because patient satisfaction surveys are not primarily focused on evaluating nursing performance specifically. Choice D is also incorrect because the main focus of the survey is on the satisfaction of patients rather than assessing healthcare facilities.

3. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

• A. Hypotension
• B. Distended neck veins
• C. Slow capillary refill
• D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

4. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?

• A. Urine is positive for ketones
• B. Urine has an unusual odor
• C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
• D. Bladder scan shows 525 mL of urine

Correct answer: A

Rationale: The correct answer is A. Ketones in the urine may indicate infection or blockage in the urinary catheter, necessitating irrigation to ensure proper drainage. Choice B, an unusual odor in the urine, may suggest infection but does not directly indicate the need for catheter irrigation. Choice C, a high urine specific gravity, is indicative of concentrated urine but does not specifically point to the need for catheter irrigation. Choice D, a bladder scan showing 525 mL of urine, indicates urine retention, which may require catheterization or further assessment but not necessarily irrigation.

5. A 26-year-old patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to administer the morning insulin?

• A. Thigh
• B. Buttock
• C. Abdomen
• D. Upper arm

Correct answer: C

Rationale: The correct answer is the abdomen. When a patient engages in physical activities like riding a bicycle, the abdomen is a suitable site for insulin administration due to the consistent absorption rate. The subcutaneous tissue in the abdomen allows for more predictable insulin absorption compared to other sites. The thigh is also a common site for insulin injection but may not be ideal for this patient due to the physical activity involved. The buttock and upper arm are not preferred sites for insulin injection as they can have variable absorption rates and may not be as convenient for self-administration.

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