Nursing Elites

1. Which of the following best describes the purpose of benchmarking in healthcare?

• A. To compare performance metrics across organizations
• B. To identify best practices and implement them
• C. To ensure compliance with standards
• D. To develop new clinical guidelines

Correct answer: B

Rationale: The correct answer is B: 'To identify best practices and implement them.' Benchmarking in healthcare aims to compare performance metrics across organizations to identify the most effective practices and implement them. This helps healthcare providers improve their performance and outcomes by adopting proven successful strategies. Choices A, C, and D are incorrect because while benchmarking may involve comparing performance metrics and ensuring standards compliance, its primary purpose is to identify and implement best practices.

2. A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse implement for this client?

• A. Have the client wear a mask when receiving visitors.
• B. Limit the client's time with visitors to no more than 30 minutes per day.
• C. Assign the client to a room with negative-pressure airflow exchange.
• D. Wear a gown when caring for the client.

Correct answer: B

Rationale: The correct answer is B because limiting the client's time with visitors helps prevent the spread of shigella infection to others. Shigella is transmitted through the fecal-oral route, so minimizing contact time reduces the risk of transmission. Choice A is incorrect as there is no need for the client to wear a mask in this situation. Choice C is also incorrect as negative-pressure airflow exchange rooms are typically used for clients with airborne infections. Choice D is incorrect as wearing a gown is not the primary precaution needed for shigella infection.

3. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

4. A new manager is implementing an initiative with the desired outcome of having the unit run more smoothly. What quality is the manager demonstrating?

• A. Being unrealistic
• B. Being a change agent
• C. Being democratic
• D. Being authoritarian

Correct answer: B

Rationale: The correct answer is B: Being a change agent. The manager is demonstrating the quality of being a change agent by implementing an initiative aimed at improving the unit's operations. A change agent initiates and drives changes to enhance effectiveness and efficiency within the unit. Choice A is incorrect because the manager's actions are not described as unrealistic but rather proactive. Choice C, being democratic, is incorrect as it does not relate to the manager's initiative to improve unit operations. Choice D, being authoritarian, is also incorrect as the manager is not described as enforcing changes through strict control and power.

5. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?

• A. Carefully assess and document client status.
• B. Ensure all patient information is logged out and the nurse has signed out of the computer before leaving the computer station.
• C. Keep careful notes while providing care to ensure accurate documentation later in the day.
• D. Discuss safety needs with clients.

Correct answer: A

Rationale: The correct answer is A: Carefully assess and document client status. By carefully assessing and documenting the client's status, healthcare providers can ensure they have a clear understanding of the client's condition, needs, and any potential risks. This helps in providing appropriate care and avoiding situations that may lead to charges of negligence or false imprisonment. Choice B is incorrect because logging out of computer systems is more related to data security and confidentiality rather than preventing negligence or false imprisonment. Choice C is not directly related to avoiding charges of negligence and false imprisonment but rather ensuring accurate documentation. Choice D, while important for overall client safety, does not specifically address the issue of avoiding charges of negligence and false imprisonment for confused clients.

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