Nokea
A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the
patient has been away from the nursing unit for 2 hours, missing the lunch delivery while
awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to
- A. save the lunch tray for the patient’s later return to the unit
- B. ask that diagnostic testing area staff to start a 5% dextrose IV
- C. send a glass of milk or orange juice to the patient in the diagnostic testing area
- D. request that if testing is further delayed, the patient be returned to the unit to eat.
Correct Answer: D
Rationale: The correct answer is D. It is essential to maintain the patient's blood glucose levels to prevent hypoglycemia. Since the patient missed lunch, returning them to the unit to eat ensures timely access to food for glycemic control. This action addresses the immediate need for nutrition and glucose intake.
A: Saving the lunch tray is not immediate and does not address the patient's current hypoglycemia risk.
B: Starting a dextrose IV is an option for severe hypoglycemia, not for preventing it in this scenario.
C: Sending milk or orange juice may help raise blood sugar but does not address the need for a complete meal to prevent hypoglycemia.
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What is the focus of a continuous quality improvement program?
- A. Family
- B. Client
- C. Nurse
- D. Physician
Correct Answer: B
Rationale: The correct answer is B: Client. In a continuous quality improvement program, the primary focus should be on improving the quality of care and services provided to the clients or patients. This ensures that their needs and preferences are met, resulting in better outcomes. A focus on the family (A) or healthcare providers like nurses (C) and physicians (D) may be important, but the ultimate goal of a quality improvement program is to enhance the client's experience and well-being. By prioritizing the client, the program can address issues directly affecting them and tailor improvements to meet their specific needs.
Which information is most important for the nurse to report to the health care provider before
a patient with type 2 diabetes is prepared for a coronary angiogram?
- A. The patient’s most recent HbA1C was 6.5%
- B. The patient’s admission blood glucose is 128 mg/dL.
- C. The patient took the prescribed metformin (Glucophage) today
- D. The patient took the prescribed captopril (Capoten) this morning.
Correct Answer: C
Rationale: The correct answer is C because metformin is typically held before a coronary angiogram due to the risk of lactic acidosis. This information is crucial for the health care provider to know to prevent potential complications during the procedure. Option A is not as urgent as the patient's current medication status. Option B is less relevant as it does not impact the procedure directly. Option D is important but not as critical as knowing the status of metformin intake. Reporting the patient's current medication, especially metformin, is vital for ensuring patient safety during the coronary angiogram.
A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?
- A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
- B. Incompetence only impacts the individual nurse.
- C. The director should follow her institution’s formal process for reporting and handling practices that jeopardize patient safety.
- D. Most nurse practice acts direct how to handle incompetent nurses.
Correct Answer: C
Rationale: The correct answer is C because the director should follow the institution's formal process for reporting and handling practices that jeopardize patient safety. This is crucial to maintain high standards of patient care and ensure accountability. Choice A is incorrect as tolerating incompetence can lead to serious consequences for patient safety. Choice B is incorrect as incompetence can impact patient outcomes and overall quality of care. Choice D is incorrect as nurse practice acts may provide guidelines but the institution's specific process should be followed to address incompetence effectively.
Which of the following is an example of a primary prevention strategy in public health?
- A. Screening for diabetes
- B. Vaccination programs
- C. Emergency response planning
- D. Chronic disease management
Correct Answer: B
Rationale: The correct answer is B: Vaccination programs. Primary prevention aims to prevent the onset of disease before it occurs. Vaccination programs are a classic example as they protect individuals from contracting infectious diseases, thus preventing the occurrence of the disease in the first place. Screening for diabetes (A) is a form of secondary prevention, aiming to detect the condition early to prevent complications. Emergency response planning (C) focuses on preparedness for disasters rather than preventing diseases. Chronic disease management (D) involves managing existing conditions rather than preventing their occurrence.
Cultural diversity presents an important challenge to nurse managers due to which of the following?
- A. A nursing shortage exists
- B. Staff nurses are not trained to be culturally sensitive
- C. 80% of nursing staff comes from one or more minority groups
- D. The increase in cultural diversity is seen both in the patient population and the nursing staff
Correct Answer: D
Rationale: The correct answer is D because an increase in cultural diversity in both the patient population and nursing staff can lead to challenges in communication, understanding beliefs and practices, and providing culturally competent care. This can impact patient outcomes and require nurse managers to address cultural competence training and policies.
Choice A (nursing shortage) is incorrect as it does not directly relate to the challenge of cultural diversity. Choice B (lack of cultural sensitivity training) may contribute to the challenge but is not the primary reason. Choice C (80% of nursing staff from minority groups) is incorrect as it presents a specific statistic without addressing the broader implications of cultural diversity in both patients and staff.