A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

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.

Correct Answer: A

Rationale: The correct answer is A because it prioritizes client autonomy and respects their wishes. By engaging the client and asking why they want to discuss advance directives without their partner present, the nurse acknowledges the client's right to make decisions about their own healthcare. This approach promotes open communication and allows the client to express their concerns and preferences freely. Choice B is incorrect as it assumes the client only needs information and brochures without addressing their specific needs or concerns. Choice C is incorrect as it delays addressing the client's immediate questions and concerns about advance directives. Choice D is incorrect as it disregards the client's request to discuss advance directives and focuses solely on their current feelings.

Correct Answer: D

Rationale: The correct answer is D because asking construction workers to be responsible for the equipment and sharp items used is not within the charge nurse's role or authority. The responsibility for ensuring safety and security in the Emergency Department lies with the healthcare staff (including the charge nurse) and security personnel. Construction workers may not have the training or expertise to handle agitated patients or prevent potential incidents. A: Notifying the nursing supervisor (A) can help escalate the issue and involve higher authority in addressing the safety concern. B: Notifying security (B) is essential to ensure that trained professionals are present to handle security-related issues. C: Having staff check patients (C) is important to verify their safety, but it does not address the primary concern of preventing patients from accessing construction equipment as weapons.

Correct Answer: A

Rationale: The correct answer is A: Twelve months. In traditional rating scales, evaluations are typically conducted over a period of twelve months to allow for a comprehensive assessment of an individual's performance over an extended period. This timeframe allows for a more accurate reflection of the individual's overall performance, taking into account various factors and performance trends throughout the year. Explanation for why the other choices are incorrect: - B: Six months: Six months is a relatively shorter timeframe compared to the traditional annual evaluation period. It may not provide a comprehensive view of the individual's performance over a longer period. - C: Three months: Three months is too short of a timeframe to evaluate performance comprehensively. It may not capture long-term performance trends and variations. - D: One month: One month is too brief to assess performance effectively. It may not account for fluctuations in performance or provide a holistic view of the individual's capabilities over time.

Correct Answer: C

Rationale: The correct answer is C because the patient with hyperosmolar hyperglycemic syndrome showing signs of poor skin turgor and dry oral mucosa is at risk for severe dehydration and potential complications. Assessing this patient first is crucial to address their immediate needs. Choice A is incorrect as the 19-year-old with possible dawn phenomenon can be assessed after the patient with hyperosmolar hyperglycemic syndrome who is at higher risk. Choice B is incorrect as a blood glucose reading of 230 mg/dL in a 35-year-old with type 1 diabetes is high but not indicative of an immediate life-threatening situation compared to severe dehydration. Choice D is incorrect as the 68-year-old with peripheral neuropathy and foot pain, while in discomfort, does not present an immediate threat to their life like severe dehydration does in a patient with hyperosmolar hyperglycemic syndrome.

Correct Answer: A

Rationale: The correct answer is A because interprofessional collaboration in healthcare involves different healthcare professionals working together as a team to provide comprehensive care and improve patient outcomes. This teamwork allows for a holistic approach to patient care, utilizing the expertise of each team member. Choice B is incorrect as it refers to working independently, which goes against the collaborative nature of interprofessional collaboration. Choice C is incorrect as it focuses on standardized protocols rather than the collaboration between professionals. Choice D is also incorrect as it pertains to sharing patient information electronically, which is just one aspect of collaboration and not the main focus.

Correct Answer: B

Rationale: The correct answer is B: Total quality management. This approach focuses on meeting customer needs and continuous improvement. By allowing the client to rest, the nurse is prioritizing the client's comfort and well-being, which aligns with the principles of total quality management. Continuous quality improvement (A) focuses on incremental improvements, Six Sigma (C) aims to reduce defects, and Quality management (D) is a broader term that encompasses various quality approaches.

Correct Answer: C

Rationale: The correct answer is C because in a high-volume maternity unit that uses differentiated practice, new graduates can expect their initial level of practice responsibility to be limited. This is because differentiated practice involves assigning tasks based on the individual nurse's skills and experience level. New graduates are typically assigned less complex tasks initially to ensure patient safety. Choice A is incorrect because evidence-based practice and risk management principles are not directly related to the staffing model being used. Choice B is incorrect because client teaching is typically a shared responsibility among all team members, not solely the team leader. Choice D is incorrect because in differentiated practice, client assignments are based on individual skills and competencies, not seniority.

Correct Answer: C

Rationale: The main focus of health literacy initiatives is to ensure that patients understand their health information. This is important for empowering individuals to make informed decisions about their health. Promoting the use of medical jargon (Option A) would actually hinder comprehension. Improving patient communication skills (Option B) is beneficial but not the main focus. Reducing the use of electronic health records (Option D) is not related to enhancing patient understanding.