Nursing Elites

1. Which technique or method is used to determine whether or not the patient has an irregular pulse?

• A. Apical pulse
• B. Inspection
• C. Auscultation
• D. Percussion

Correct answer: A

Rationale: An apical pulse check is used to determine if the patient has an irregular pulse. The apical pulse is located at the point of maximal impulse (PMI) and is assessed using a stethoscope. Choice B, inspection, involves visual examination and is not used to assess pulse irregularities. Choice C, auscultation, involves listening to internal sounds using a stethoscope, which can be used to assess heart sounds but not specifically for pulse irregularities. Choice D, percussion, is a technique used to assess the density of body tissues or detect abnormal masses and is not used to determine pulse irregularities.

2. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should:

• A. Call the physician
• B. Encourage the intake of fluids
• C. Administer the insulin as ordered
• D. Give the client ½ cup of orange juice

Correct answer: C

Rationale: In this scenario, the client with type 1 DM has a high glucose level at bedtime. The appropriate action for the nurse is to administer the sliding scale insulin as ordered. This insulin regimen is specifically designed to manage high blood glucose levels. Calling the physician is not necessary as the protocol for sliding scale insulin is already in place. Encouraging fluid intake or providing orange juice is not the correct intervention for addressing high blood glucose levels in this case.

3. Which of the following changes was enacted by the Patient Protection and Affordable Care Act?

• A. Creation of national health insurance exchanges for affordable insurance coverage
• B. Expansion of school-based health centers
• C. Free preventative services for all
• D. Medically managed clinics eligible for federal funding

Correct answer: B

Rationale: The correct answer is B. The Patient Protection and Affordable Care Act expanded school-based health centers to provide additional healthcare services to students. Choice A is incorrect because the creation of national health insurance exchanges was a key provision of the Affordable Care Act, but it was not the only change enacted by the legislation. Choice C is incorrect as while the Affordable Care Act did include provisions for free preventative services for certain groups, it was not applicable to all individuals. Choice D is incorrect as the Act did not specifically address medically managed clinics eligible for federal funding.

4. Which of the following is a common barrier to effective communication in healthcare?

• A. Active listening
• B. Cultural differences
• C. Clear language
• D. Empathy

Correct answer: B

Rationale: Cultural differences are a common barrier to effective communication in healthcare. When individuals from different cultures interact in healthcare settings, varying communication styles, beliefs, values, and language barriers can hinder effective communication. This can lead to misunderstandings, misinterpretations, and ultimately impact the quality of care provided. Active listening (choice A) is a communication skill that helps improve understanding and can actually enhance communication. Clear language (choice C) is essential for effective communication and can help overcome barriers, rather than being a barrier itself. Empathy (choice D) is important in healthcare to understand patients' emotions and perspectives, but it is not a common barrier to effective communication.

5. Which of the following is something a new model for health care in the future should include?

• A. Community-centered care
• B. Care that encourages a healthy environment
• C. Accessible care that is affordable for most
• D. A focus on local health concerns

Correct answer: B

Rationale: The correct answer is B because a new model for health care in the future should focus on promoting a healthy environment. This includes initiatives such as green buildings and reducing pollution to improve overall health outcomes. Choice A, community-centered care, is important but not the primary focus when considering the future of healthcare. Choice C, accessible and affordable care, is crucial but does not directly address the need for a healthy environment. Choice D, a focus on local health concerns, is relevant but not as comprehensive as promoting a healthy environment in shaping the future of healthcare.

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