Nokea
A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?
- A. Infuse 1 liter of normal saline per hour.
- B. Give sodium bicarbonate 50 mEq IV push.
- C. Administer regular insulin 10 U by IV push.
- D. Start a regular insulin infusion at 0.1 units/kg/hr.
Correct Answer: A
Rationale: The correct answer is A because the priority in treating diabetic ketoacidosis is fluid resuscitation to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps to restore intravascular volume and corrects electrolyte abnormalities. Choice B (sodium bicarbonate) is not recommended routinely in DKA treatment as it may worsen metabolic acidosis. Choice C (IV push insulin) can lead to hypoglycemia and should not be the initial intervention. Choice D (insulin infusion) is important but should be started after fluid resuscitation to avoid rapid drops in blood glucose levels.
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The nurse manager is talking with the CNA about her time management. Which of the following is an example of a nurse manager as a coach?
- A. Your timely response to patients' call lights is exemplary.
- B. Your appearance is seldom professional.
- C. You must get the vital signs taken on time or you will be disciplined.
- D. You never report AM blood sugar levels on time.
Correct Answer: A
Rationale: The correct answer is A because it provides positive reinforcement for a behavior that the nurse manager wants to encourage. By praising the CNA for her timely response to patients' call lights, the nurse manager is acting as a coach by recognizing and reinforcing a positive behavior. This approach is motivational and helps the CNA understand the importance of time management in a positive manner.
Choice B is incorrect because it focuses on the CNA's appearance, which is not directly related to time management or coaching. Choice C is incorrect as it uses a threat of discipline rather than coaching to address the issue of vital signs being taken on time. Choice D is incorrect as it uses a negative statement without providing constructive feedback or coaching to address the issue of reporting blood sugar levels on time.
Which of the following best describes the role of a nurse preceptor?
- A. Supervisor of all nursing staff
- B. Mentor and educator for new nurses
- C. Director of nursing services
- D. Coordinator of patient care
Correct Answer: B
Rationale: The correct answer is B: Mentor and educator for new nurses. A nurse preceptor guides and supports new nurses in their transition to the workplace, providing mentorship and educational resources. This role involves teaching clinical skills, sharing knowledge, and offering emotional support.
A: Supervisor of all nursing staff - Incorrect. A nurse preceptor focuses on mentoring new nurses, not supervising all nursing staff.
C: Director of nursing services - Incorrect. The director of nursing services is a higher-level administrative position responsible for overseeing the nursing department.
D: Coordinator of patient care - Incorrect. While a nurse preceptor may assist in coordinating patient care for their assigned nurse, their primary role is to mentor and educate new nurses.
A nurse is caring for a client after knee replacement surgery. The nurse discovers that the consent was not signed before the surgery. Which of the following charges could be filed?
- A. False imprisonment
- B. Libel
- C. Battery
- D. Malpractice
Correct Answer: C
Rationale: The correct answer is C: Battery. In this scenario, performing surgery without obtaining consent constitutes battery, which is the intentional touching of another person without consent. It is a violation of the client's right to autonomy and self-determination. False imprisonment (A) involves restraining someone without justification. Libel (B) is a written defamation of character, and malpractice (D) refers to professional negligence in providing healthcare services. Battery is the most appropriate charge in this situation as it directly addresses the lack of consent for the surgery.
What quality is observed among individuals who strive to find the best way to do their job?
- A. Punctuality
- B. Strictness
- C. Honesty
- D. Motivation
Correct Answer: D
Rationale: The correct answer is D: Motivation. Individuals who strive to find the best way to do their job are motivated to continuously improve and excel in their work. Motivation drives them to seek out better methods, innovate, and push boundaries for greater efficiency and effectiveness. Punctuality (A) relates more to timeliness, strictness (B) implies rigidity rather than adaptability, and honesty (C) is important but not directly related to the drive for improvement. Overall, motivation is the key factor that propels individuals to constantly seek the best ways to perform their job.
A registered nurse (RN) is caring for a patient who is one of Jehovah’s Witnesses and has refused a blood transfusion even though her hemoglobin is dangerously low. After providing information about all the alternatives available and risks and benefits of each, the health-care provider allows the patient to determine which course of treatment she would prefer. The RN knows this is an example of which ethical principle?
- A. Autonomy
- B. Nonmaleficence
- C. Beneficence
- D. Distributive justice
Correct Answer: A
Rationale: The correct answer is A: Autonomy. Autonomy is the ethical principle that emphasizes respecting the patient's right to make their own decisions about their healthcare. In this scenario, the RN respects the patient's autonomy by providing all necessary information and allowing the patient to choose whether or not to accept a blood transfusion, despite the potential risks. This decision-making process aligns with the patient's right to self-determination.
Summary of other choices:
B: Nonmaleficence - Focuses on avoiding harm to the patient, but in this case, the patient's autonomy takes precedence over nonmaleficence.
C: Beneficence - Involves acting in the patient's best interest, but in this scenario, the patient's autonomy to make decisions is the primary focus.
D: Distributive justice - Concerns fair distribution of resources, which is not directly relevant to the patient's right to autonomy in decision-making.