Nursing Elites

1. Which of the following should be included in a discussion of advance directives with new nurse graduates?

• A. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
• B. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so.
• C. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions.
• D. The advance directive designates a health-care surrogate who will make known the client’s wishes regarding medical treatment if the client is unable to do so.

Correct answer: A

Rationale: According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.

2. During a staffing crisis, managers may need to use nurse extenders. These individuals are better known as:

• A. Float RNs.
• B. Unlicensed assistive personnel.
• C. LPNs.
• D. Agency nurses.

Correct answer: B

Rationale: During a staffing crisis, managers may need to utilize unlicensed assistive personnel (UAPs) as nurse extenders. UAPs help free up nurses' time, enabling them to focus more on direct client care. Float RNs (Choice A) refer to registered nurses who work in various units as needed, not specifically as nurse extenders during crises. LPNs (Choice C) are licensed practical nurses, not typically used as nurse extenders. Agency nurses (Choice D) are temporary nurses hired from external agencies, not necessarily designated as nurse extenders.

3. When a client who is in pain refuses to be repositioned, what should the nurse consider first in making a decision about what to do?

• A. Why a decision is needed.
• B. Who actually gets to make the decision?
• C. What are the alternatives?
• D. When a decision is needed.

Correct answer: A

Rationale: In this scenario, the nurse should first consider why a decision is needed. Understanding the underlying reason for the decision helps in selecting the best action to meet the desired goal. Who actually makes the decision is important but not the primary consideration. Exploring alternatives comes after determining the reason for the decision, who makes it, and when it is needed.

4. After a violent incident, staff needs to discuss what occurred. Several actions need to be taken following the incident:

• A. Debrief the staff and complete incident reports and verify that all staff are safe
• B. Reassure the violent patient that hurting staff when ill is not cause for concern
• C. Avoid any interactions
• D. Standing close to the patient while talking

Correct answer: A

Rationale: Corrected Rationale: After a violent incident, it is crucial to debrief the staff and complete incident reports to document what occurred and ensure proper follow-up actions. Verifying that all staff are safe is essential for their well-being and security. This process allows professionals to assess the situation, learn from it, and be better prepared to handle similar incidents in the future. Choice B is incorrect because reassuring a violent patient that hurting staff is not a cause for concern may diminish the seriousness of the incident. Choice C is incorrect as avoiding interactions does not address the need for proper communication and resolution. Choice D is incorrect as standing close to a patient who has been violent may escalate the situation and compromise safety.

5. Which action by a patient indicates that the home health nurse’s teaching about glargine and regular insulin has been successful?

• A. The patient administers the glargine 30 minutes before each meal
• B. The patient’s family prefills the syringes with the mix of insulins weekly.
• C. The patient draws up the regular insulin and then the glargine in the same syringe.
• D. The patient disposes of the open vials of glargine and regular insulin after 4 weeks

Correct answer: D

Rationale:

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