Nursing Elites

1. Which of the following is true regarding the Affordable Care Act?

• A. The Affordable Care Act addressed issues of interest to nursing without controversy.
• B. The Affordable Care Act addressed issues of mandatory overtime, incivility, and high workloads for nurses.
• C. The Affordable Care Act provided a new patient-centered model for health care.
• D. The Affordable Care Act attempted to address many of the issues of interest to nursing, but came with much controversy.

Correct answer: D

Rationale: The correct answer is D. The Affordable Care Act attempted to address many issues relevant to nursing, such as mandatory overtime, incivility, and high workloads, but it faced significant controversy. Choice A is incorrect as the act did not address nursing issues without controversy. Choice B is incorrect as it inaccurately lists the issues the act addressed. Choice C is incorrect as it does not fully capture the controversy surrounding the Affordable Care Act.

2. A nurse is assessing an older adult client who was brought to the emergency department by his son, who reports that the client fell at home. The nurse suspects elder abuse. Which of the following actions should the nurse take?

• A. File an incident report.
• B. Ask the client about his injuries with the son present.
• C. Ask the client's son to go to the waiting area.
• D. Treat and discharge the client

Correct answer: C

Rationale: The correct action for the nurse to take is to ask the client's son to go to the waiting area. This allows the nurse to interview the client independently to assess for signs of elder abuse without the son's potential influence. Filing an incident report may be necessary later but is not the immediate action required. Asking about injuries with the son present could lead to biased responses or intimidation. Treating and discharging the client without addressing the suspicion of elder abuse would neglect the nurse's responsibility to ensure the client's safety.

3. Which atrioventricular heart block is also referred to as Mobitz II?

• A. Third-degree atrioventricular heart block
• B. Second-degree atrioventricular heart block
• C. First-degree atrioventricular heart block
• D. Complete heart block

Correct answer: B

Rationale: The correct answer is B. Second-degree atrioventricular heart block is also known as Mobitz II. In Mobitz II, some atrial impulses are blocked from reaching the ventricles, resulting in occasional dropped beats. Third-degree atrioventricular heart block is known as complete heart block, where no atrial impulses reach the ventricles. First-degree atrioventricular heart block is a condition where there is delayed conduction between the atria and ventricles but all atrial impulses are eventually conducted to the ventricles.

4. Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what this means. What is the best response by the nurse? Select the one that does not apply.

• A. Your beta cells should be able to secrete insulin, but cannot.
• B. The endocrine function of your pancreas is to secrete insulin.
• C. Without insulin, you will develop ketoacidosis (DKA).
• D. The exocrine function of your pancreas is to secrete Estrogen.

Correct answer: D

Rationale: Type 1 diabetes is characterized by the inability of the beta cells in the pancreas to secrete insulin. Choice A is correct because it highlights the role of beta cells. Choice B is accurate as the endocrine function of the pancreas includes insulin secretion. Choice C is true as without insulin, ketoacidosis can develop. Choice D is incorrect as the exocrine function of the pancreas involves secreting digestive enzymes, not estrogen.

5. Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select one that does not apply.

• A. The nurse could have given the insulin subcutaneously.
• B. The nurse did not have to contact the physician.
• C. The nurse should have used regular insulin (Humulin R).
• D. The nurse used the correct insulin.

Correct answer: C

Rationale: The best evaluation of the nurse reveals that she should have used regular insulin (Humulin R) for IV administration. Regular insulin is the only insulin approved for intravenous administration due to its pharmacokinetic properties. Insulin lispro (Humalog) is not suitable for IV use. Choice A is incorrect because giving insulin intravenously is necessary in this case of high blood sugar. Choice B is incorrect because administering a different insulin without consulting the physician is not appropriate. Choice D is incorrect because the nurse used the incorrect insulin, which could pose risks to the client's health.

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