Nokea
What is the primary goal of a clinical nurse leader (CNL)?
- A. To manage the nursing staff
- B. To coordinate patient care
- C. To improve patient outcomes
- D. To implement evidence-based practices
Correct Answer: C
Rationale: The primary goal of a clinical nurse leader (CNL) is to improve patient outcomes. CNLs focus on enhancing the quality of care provided to patients by coordinating and overseeing healthcare processes. They work to ensure that patients receive the best possible care and achieve positive health outcomes. Managing nursing staff (A) is not the primary goal of a CNL, as their role is more patient-centered. While coordinating patient care (B) is an important aspect of a CNL's responsibilities, the ultimate goal is to improve patient outcomes. Implementing evidence-based practices (D) is essential for achieving better patient outcomes, but it is not the primary goal of a CNL, as their main focus is on the overall improvement of patient health and well-being.
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In preparation for a client's procedure with a latex allergy, which of the following precautions should the nurse take?
- A. Ensure sterilization of nondisposable items with ethylene oxide.
- B. Wear hypoallergenic latex gloves that do not contain powder.
- C. Cleanse latex ports on IV tubing with chlorhexidine before injecting medication.
- D. Wrap monitoring cords with stockinette and tape them in place.
Correct Answer: B
Rationale: The correct answer is B: Wear hypoallergenic latex gloves that do not contain powder. This is the best precaution because it minimizes the risk of the client having an allergic reaction to latex during the procedure. Powdered latex gloves can release latex particles into the air, increasing the likelihood of a reaction. Hypoallergenic gloves are designed to reduce the risk of allergic responses.
Choice A is incorrect as ethylene oxide is used for sterilization of medical equipment, not specifically for latex allergy precautions. Choice C is incorrect because cleansing latex ports with chlorhexidine does not address the risk of latex exposure. Choice D is also incorrect as wrapping monitoring cords does not directly address the issue of latex allergy.
A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?
- A. The patient always carries hard candies when engaging in exercise.
- B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
- C. The patient has a peanut butter sandwich before going for a bicycle ride.
- D. The patient increases daily exercise when ketones are present in the urine.
Correct Answer: D
Rationale: The correct answer is D. Increasing exercise when ketones are present can worsen diabetic ketoacidosis. A patient should not exercise with ketones in urine. Carrying candies for exercise (A) helps manage low blood sugar. Going for a walk with a glucose of 200 mg/dL (B) can help lower blood sugar. Eating a sandwich before exercise (C) provides fuel.
A registered nurse (RN) administered a patient’s morning insulin as the breakfast tray arrived at 0800. The RN performed a complete assessment at the same time. Then, the RN got busy with her other patients and did not check on the patient until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. Which of the following could the RN be charged with?
- A. Quasi-intentional tort
- B. Misdemeanor
- C. Negligence
- D. Juvenile offense
Correct Answer: C
Rationale: The correct answer is C: Negligence. The RN failed to monitor the patient after administering insulin, leading to a critical situation. Negligence in nursing involves a breach of duty of care that results in harm to the patient. In this case, the RN's failure to check on the patient for several hours directly contributed to the patient becoming unresponsive with dangerously low blood glucose levels. This constitutes a clear case of nursing negligence.
A: Quasi-intentional tort involves intentional actions that result in harm, such as defamation or invasion of privacy. This scenario does not involve intentional harm.
B: Misdemeanor refers to a criminal offense less serious than a felony. Negligence in nursing is typically addressed through civil, not criminal, proceedings.
D: Juvenile offense pertains to actions committed by minors. The RN is a healthcare professional, not a minor, and the offense here is related to professional negligence, not juvenile misconduct.
According to Maslow's theory, which level of needs must be met first?
- A. Self-actualization needs
- B. Esteem needs
- C. Safety needs
- D. Physiological needs
Correct Answer: D
Rationale: The correct answer is D: Physiological needs. According to Maslow's hierarchy of needs, physiological needs such as food, water, shelter, and sleep must be met first as they are the most basic and essential for survival. Without satisfying physiological needs, an individual cannot move on to fulfilling higher-level needs. Esteem needs, self-actualization needs, and safety needs come after physiological needs are met. It is crucial to prioritize physiological needs before addressing other levels of needs to ensure overall well-being and self-actualization.
A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?
- A. Lispro (Humalog)
- B. Glargine (Lantus)
- C. Detemir (Levemir)
- D. NPH (Humulin N)
Correct Answer: A
Rationale: The correct answer is A: Lispro (Humalog). Lispro is a rapid-acting insulin that is ideal for mealtime coverage in intensive insulin therapy because it mimics the body's natural insulin response after a meal, providing quick and effective blood sugar control. Lispro has a rapid onset of action, peaks quickly, and has a shorter duration of action compared to other types of insulin. This makes it suitable for covering the rise in blood sugar levels that occurs after meals.
Summary of why other choices are incorrect:
B: Glargine (Lantus) is a long-acting insulin used for basal coverage, not for mealtime coverage.
C: Detemir (Levemir) is an intermediate-acting insulin used for basal coverage, not for mealtime coverage.
D: NPH (Humulin N) is an intermediate-acting insulin with a slower onset and longer duration of action, making it less suitable for mealtime coverage in intensive insulin therapy.