Nursing Elites

1. Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient?

• A. Intravenous potassium supplementation
• B. Intravenous calcium supplementation
• C. Kidney dialysis
• D. Parenteral nutrition

Correct answer: C

Rationale: The correct answer is C: Kidney dialysis. A blood potassium level of 9.2 mEq/L indicates severe hyperkalemia, which can be life-threatening. Kidney dialysis is the most appropriate intervention to rapidly lower potassium levels in this situation. Choice A, intravenous potassium supplementation, would worsen the hyperkalemia. Choice B, intravenous calcium supplementation, is not the primary intervention for hyperkalemia. Choice D, parenteral nutrition, is unrelated to treating hyperkalemia and would not address the immediate concern.

2. Select the cranial nerve that is accurately paired with its name.

• A. The fourth cranial nerve: The trochlear nerve
• B. The twelfth cranial nerve: The hypoglossal nerve
• C. The tenth cranial nerve: The olfactory nerve
• D. The thirteenth cranial nerve: The auditory nerve

Correct answer: B

Rationale: The twelfth cranial nerve is the hypoglossal nerve, which controls the muscles of the tongue. The other choices are incorrect because the trochlear nerve is the fourth cranial nerve responsible for eye movement, the olfactory nerve is the first cranial nerve responsible for the sense of smell, and there are only twelve cranial nerves, so there is no thirteenth cranial nerve.

3. What is the most common cause of HHNS?

• A. Insulin overdose
• B. Removal of the adrenal gland
• C. Undiagnosed, untreated hyperpituitarism
• D. Undiagnosed, untreated diabetes mellitus

Correct answer: D

Rationale: The correct answer is D: Undiagnosed, untreated diabetes mellitus. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is most commonly caused by undiagnosed and untreated diabetes mellitus. Insulin overdose (Choice A) is not a typical cause of HHNS; it is more related to hypoglycemia. Removal of the adrenal gland (Choice B) can lead to adrenal insufficiency but is not a common cause of HHNS. Undiagnosed, untreated hyperpituitarism (Choice C) is not a usual cause of HHNS; it is more related to pituitary hormone imbalances rather than hyperglycemia.

4. A nurse is comparing the rate of medication errors on the medical unit to the rate from a medical unit in a magnet hospital. Which of the following quality improvement methods is the nurse using?

• A. Structure audit
• B. Benchmarking
• C. Risk benefit analysis
• D. Root cause analysis

Correct answer: B

Rationale: The correct answer is B: Benchmarking. Benchmarking involves comparing performance metrics with those from other units or institutions, which is exactly what the nurse is doing by comparing the rate of medication errors on their medical unit to the rate from a medical unit in a magnet hospital. Choice A, Structure audit, is not relevant to this scenario as it focuses on assessing the physical, organizational, or procedural structures in a healthcare setting. Choice C, Risk benefit analysis, involves weighing the potential risks and benefits of a particular course of action, not comparing performance metrics. Choice D, Root cause analysis, is a method used to identify the underlying causes of problems or adverse events, not to compare performance metrics between units.

5. A nurse is supervising an assistive personnel (AP) who is feeding a client who has dysphagia. Which of the following actions by the AP should the nurse identify as correct technique?

• A. Elevating the head of the client's bed to 30 degrees during mealtime
• B. Withholding fluids until the end of the meal
• C. Providing a 10-minute rest period prior to meals
• D. Instructing the client to place her chin toward her chest when swallowing

Correct answer: D

Rationale: The correct technique for a client with dysphagia is to instruct them to place their chin toward their chest when swallowing. This action helps to close off the airway during swallowing, reducing the risk of aspiration. Elevating the head of the client's bed to 30 degrees during mealtime helps prevent aspiration, but this is not the responsibility of the AP. Withholding fluids until the end of the meal can lead to dehydration and is not a recommended practice. Providing a 10-minute rest period prior to meals is not specifically related to improving swallowing safety for clients with dysphagia.

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