Nursing Elites

1. 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: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

2. The problem of overrating staff performance is called ___________ .

• A. Recency error
• B. Absolute judgment
• C. Halo error
• D. Leniency error

Correct answer: D

Rationale: The correct answer is D, 'Leniency error.' Leniency error occurs when a manager tends to overrate staff performance, giving higher ratings than deserved. Choice A, 'Recency error,' refers to the tendency to focus only on recent behaviors or events when evaluating performance. Choice B, 'Absolute judgment,' is not directly related to overrating staff performance; it refers to making evaluations without considering the context or comparison points. Choice C, 'Halo error,' involves allowing one positive aspect of an individual to overshadow other factors in performance evaluation, which is different from overrating overall staff performance.

3. As a new nurse on a pediatric unit, you must work nights and you have minimal time to spend with your children. Your colleague observes that you speak abruptly with parents and you become easily annoyed when the patients cry or when they are demanding. You realize you are becoming increasingly more distressed and that you have no time with your children and, as a result you: (Select all that apply.)

• A. Express negative comments to colleagues about patients and parents who annoy you.
• B. Ask the nurse manager to have a schedule with an equal number of day and night shifts so that you can be with your children.
• C. Call off sick as frequently as you can without violating policies so that you have more time with your children.
• D. Minimize your communication with patients and parents so you do not offend them.

Correct answer: B

Rationale: The correct answer is B. Asking the nurse manager for a schedule with an equal number of day and night shifts is a proactive and constructive approach to address the issue of having minimal time with your children. This solution aims to balance work and personal life effectively. Choices A, C, and D are incorrect. Expressing negative comments about patients and parents (Choice A) is unprofessional and can create a negative work environment. Calling off sick frequently (Choice C) is irresponsible and violates work policies, leading to potential disciplinary actions. Minimizing communication with patients and parents (Choice D) is not a suitable approach as effective communication is essential in healthcare to provide optimal care and support to patients and their families.

4. While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.

• A. Parallel
• B. Functional
• C. Service-integrated
• D. Matrix

Correct answer: B

Rationale: The correct answer is 'Functional.' In a functional structure, organizations group employees into departments based on specialty, where similar tasks are performed by the same group. In this scenario, the hospital organizing its departments by specialty such as nursing, dietary, and pharmacy aligns with the characteristics of a functional structure. Choice A, 'Parallel,' does not fit the scenario described; parallel structures involve separate, independent units operating in parallel with little interaction. Choice C, 'Service-integrated,' does not align with the scenario either as it involves integrating services across departments. Choice D, 'Matrix,' is not the correct answer as it involves a complex organizational structure where employees report to multiple managers simultaneously, which is not the case in the scenario provided.

5. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation that should be included in the reminders for ensuring legally credible nursing documentation is to 'Only use approved abbreviations.' Using shortcuts in documentation (Choice A) may lead to incomplete or vague information, compromising the credibility of documentation. Documentation should not be subjective (Choice C) but rather objective and based on factual information. While it is important to document after care is provided (Choice D), the immediate documentation following care provision is critical for accuracy and legal credibility.

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