Nursing Elites

1. Which of the following interventions is necessary before insertion of an arterial line into the radial artery?

• A. Ensure that the client does not need surgery
• B. Assess the client's grip strength
• C. Perform an Allen test
• D. Check a serum potassium level

Correct answer: C

Rationale: Before inserting an arterial line into the radial artery, it is crucial to perform an Allen test. The Allen test assesses the collateral circulation to the hand by compressing both the radial and ulnar arteries. By occluding the radial artery and releasing the ulnar artery, the nurse can check if the ulnar artery can adequately supply blood to the hand if the radial artery is cannulated. This step ensures that there is adequate circulation to the hand post-insertion of the arterial line. Choice A, ensuring that the client does not need surgery, is not directly related to the insertion of an arterial line and is not a necessary step before the procedure. Choice B, assessing grip strength, is not specific to the vascular status of the hand and does not provide information about the adequacy of collateral circulation. Choice D, checking a serum potassium level, is unrelated to the assessment of radial artery patency and collateral circulation, which are the primary concerns before arterial line insertion.

2. A client on lithium has diarrhea and vomiting. What should the nurse do first?

• A. Recognize this as a drug interaction
• B. Give the client Cogentin
• C. Reassure the client that these are common side effects of lithium therapy
• D. Hold the next dose and obtain an order for a stat serum lithium level

Correct answer: D

Rationale: Diarrhea and vomiting are manifestations of lithium toxicity. The priority action for the nurse is to hold the next dose of lithium and obtain an order for a stat serum lithium level to confirm toxicity. This ensures patient safety and prevents further harm. Recognizing it as a drug interaction is not the first step in this scenario. Cogentin is used to manage extrapyramidal symptoms (EPS) associated with antipsychotics, not lithium toxicity. Reassuring the client about these symptoms as common side effects of lithium therapy is inappropriate as they indicate a more serious issue than typical side effects like hand tremors, nausea, polyuria, and polydipsia.

3. Research participants are involved in a trial that incidentally separates them into two groups. One group receives an intervention, while the other group does not. Both groups are compared for outcomes. What type of research method is this?

• A. Experimental design
• B. Double-blind experiment
• C. Randomized controlled trial
• D. Repeated measures design

Correct answer: C

Rationale: A randomized controlled trial is a research method in which participants are randomly assigned to either a treatment or control group. This design helps eliminate bias and allows for the comparison of outcomes between the two groups. In this scenario, where participants are separated into intervention and non-intervention groups for comparison, it aligns with the characteristics of a randomized controlled trial. The key feature distinguishing it from the other options is the random assignment of participants to groups, ensuring that both groups are comparable at the start of the study. Double-blind experiments involve blinding both participants and researchers to treatment allocation, which is not explicitly mentioned in the scenario. Experimental design refers to a broader category that includes various types of research designs beyond just randomized controlled trials. Repeated measures design involves collecting multiple observations from the same participants over time, which is not the case described in the scenario.

4. A victim of a gunshot wound to the abdomen has been admitted to the hospital, accompanied by a police officer. When questioned, the officer states that the patient is a suspect in a homicide, which occurred as part of the same incident. A small child was killed as the result of a stray bullet. The patient is combative, yells that he's in pain and demands medication. What is your most appropriate response?

• A. Tell him you'll take care of him after your other patients
• B. Reinforce restraints
• C. Perform a pain assessment and administer pain medication
• D. Ask the officer for more details of the incident

Correct answer: C

Rationale: The most appropriate and caring response is to perform a pain assessment and administer the pain medication that has been ordered. Regardless of personal feelings about any given situation, the nurse's responsibility is to provide unbiased, appropriate, and supportive care, as stated in the American Nurses Association (ANA) Code of Ethics. Choice A is not appropriate as it disregards the patient's immediate need for pain relief. Choice B may escalate the situation and is not the priority in this case. Choice D is not the immediate action needed to address the patient's pain and distress.

5. Which of the following statements is true regarding non-profit organizations?

• A. They are located in various areas, not specifically poor or rural ones.
• B. They are mandated to care for people, even if clients are unable to pay for services.
• C. The money they receive for services is reinvested back into their own business to further develop services.
• D. They are not referred to as proprietary organizations.

Correct answer: B

Rationale: Non-profit organizations are entities that operate for a social cause or public benefit, and they do not distribute profits to owners or shareholders. They are not limited to being located in poor or rural areas; they can be found in various locations. One key characteristic of non-profits is that they are obligated to provide services, regardless of a client's ability to pay. This ensures that essential services are accessible to all individuals in need. The statement 'The money they receive for services is reinvested back into their own business to further develop services' is correct. Non-profit organizations reinvest any surplus funds back into their operations to enhance the services they provide. The statement 'They are not referred to as proprietary organizations' is correct because proprietary organizations are typically for-profit entities, not non-profit ones.

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