Nokea
When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?
- A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
- B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
- C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
- D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.
Correct Answer: C
Rationale: The correct answer is C: Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
Rationale:
1. Administering insulin falls under the scope of practice for an LPN/LVN.
2. Administering lispro insulin before surgery helps maintain the patient's blood glucose within a safe range during the procedure.
3. LPN/LVNs are trained to administer medications safely and accurately.
Summary:
A: Communication with the circulating nurse requires critical thinking and interpretation, which may be beyond the scope of an LPN/LVN.
B: Discussing the reason for insulin therapy involves patient education and interpretation, which are typically responsibilities of a registered nurse.
D: Planning strategies to prevent hypoglycemia or hyperglycemia requires higher-level critical thinking and assessment skills, usually performed by a registered nurse.
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Strategies to advance your career and opportunities available in your first job can coexist. Identify factors that will help you prioritize these opportunities to fulfill your goals. (Select all that apply.)
- A. Self-actualization and assessing your values and your lifestyle.
- B. Determine where you can grow and develop professionally.
- C. Your ability to work as a team member.
- D. Reflect on your long-term career aspirations.
Correct Answer: A
Rationale: The correct answer is A because self-actualization and assessing your values and lifestyle are essential for aligning your career goals with personal values, leading to long-term satisfaction and fulfillment. By understanding your core values and lifestyle preferences, you can prioritize job opportunities that align with your aspirations.
Choice B is incorrect because while professional growth is important, it may not necessarily align with your personal values and lifestyle. Choice C is incorrect as teamwork skills are important, but they do not directly relate to prioritizing career opportunities based on personal values. Choice D is incorrect as reflecting on long-term career aspirations alone may not provide a holistic view of how to prioritize opportunities in alignment with personal values and lifestyle.
A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?
- A. Increase in hematocrit
- B. Increase in respiratory rate
- C. Decrease in heart rate
- D. Decrease in capillary refill time
Correct Answer: D
Rationale: The correct answer is D: Decrease in capillary refill time. Administering 0.9% sodium chloride helps to increase blood volume and improve tissue perfusion, leading to a decrease in capillary refill time. This improvement indicates that the treatment was successful in addressing the fluid volume deficit.
A: Increase in hematocrit would not be an immediate indication of the success of fluid resuscitation as it may take time for the hematocrit levels to reflect changes in blood volume.
B: Increase in respiratory rate could indicate respiratory distress or other issues not related to the effectiveness of fluid resuscitation.
C: Decrease in heart rate could be due to various factors and may not directly correlate with the success of fluid replacement therapy.
In summary, the most immediate and direct indicator of successful fluid resuscitation in this scenario is a decrease in capillary refill time.
An RN comes upon a serious motor vehicle accident that has just occurred and no first responders are on the scene. One car has been flipped upside down, and she can see the driver still in the car. The RN decides to stop and help. She knows she is protected from civil liability as long as she does which of the following?
- A. Acts in an ordinary, reasonable, and prudent professional manner
- B. Assures that information obtained is not communicated to anyone else
- C. Does not make any verbal comments that could lead to economic harm
- D. Fails to meet the established standards of practice
Correct Answer: A
Rationale: The correct answer is A: Acts in an ordinary, reasonable, and prudent professional manner. The RN is protected from civil liability under the Good Samaritan laws when they act in a manner that is considered ordinary, reasonable, and prudent for a healthcare professional in an emergency situation. By stopping to help at the accident scene, the RN is fulfilling their duty to provide aid as a healthcare professional. Choices B and C are incorrect because withholding information or refraining from making certain verbal comments would not protect the RN from liability in this emergency scenario. Choice D is incorrect because failing to meet the established standards of practice would expose the RN to potential liability.
Which of the following is an example of total time lost?
- A. Number of days off that an employee asks for
- B. Number of scheduled days missed
- C. Number of days missed
- D. Number of days perceived to be absent
Correct Answer: B
Rationale: The correct answer is B: Number of scheduled days missed. Total time lost refers to the actual working days that were missed as per the employee's schedule. Choice A considers only the days off requested, which may not align with the actual days missed. Choice C is incorrect because it does not specify if the days missed were part of the schedule. Choice D is incorrect as it refers to perception rather than actual days missed. Therefore, B is the most accurate measure of total time lost in terms of work productivity.
A nurse is caring for a client who has a nasogastric (NG) tube and is receiving intermittent
feedings through an open system. Which of the following actions should the nurse take first?
- A. Make sure the enteral formula is at room temperature.
- B. Wipe the top of the formula can with alcohol.
- C. Rinse the feeding bag with water between feedings.
- D. Tell the client to keep the head of the bed elevated at least 30°
Correct Answer: B
Rationale: The correct answer is B: Wipe the top of the formula can with alcohol. This is the first action the nurse should take because it ensures the cleanliness and sterility of the formula before administering it to the client through the NG tube, reducing the risk of contamination and infection.
A: Making sure the enteral formula is at room temperature is important but not the first action to take.
C: Rinsing the feeding bag with water between feedings is not necessary for every feeding and does not address the immediate need to ensure the cleanliness of the formula.
D: Instructing the client to keep the head of the bed elevated is important for preventing aspiration but is not the first action to take in this scenario.