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. A new nurse manager is attempting to solve a management issue by using one solution after another until she solves the problem. This would be known as what type of method?

• A. Decision making
• B. Trial and error
• C. Experimentation
• D. Analysis

Correct answer: B

Rationale: The correct answer is B. Trial and error is a method used by new managers to solve problems by trying different solutions until one is successful. In this scenario, the nurse manager is using a trial and error approach by attempting various solutions until the issue is resolved. Choices A, C, and D are incorrect because decision making involves making choices based on available information, experimentation involves testing hypotheses in a controlled setting, and analysis entails examining data and information to gain insights or draw conclusions, none of which directly reflect the iterative process of trial and error.

3. What is the best description of cultural competence in nursing?

• A. Ignoring cultural differences
• B. Adapting care to cultural needs
• C. Learning about different cultures
• D. Teaching cultural awareness

Correct answer: B

Rationale: Cultural competence in nursing means adapting care to meet the cultural needs of patients. This involves understanding and respecting the cultural differences of individuals to provide effective and appropriate healthcare. Choice A is incorrect because ignoring cultural differences goes against the essence of cultural competence. Choice C is not the best description as cultural competence is more than just learning about different cultures; it is about applying that knowledge in providing care. Choice D is not the best description as teaching cultural awareness is only a part of developing cultural competence, but it also requires practical application in care delivery.

4. The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose

• A. washes the puncture site using warm water and soap
• B. chooses a puncture site in the center of the finger pad
• C. hangs the arm down for a minute before puncturing the site
• D. says the result of 120 mg indicates good blood sugar control

Correct answer: B

Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad is not recommended for blood glucose monitoring. The recommended sites are the sides of the fingertips. Option A is correct as washing the puncture site using warm water and soap is a good practice. Option C is also correct as hanging the arm down for a minute can help increase blood flow. Option D is incorrect as a blood sugar level of 120 mg/dL may not necessarily indicate good blood sugar control and needs further interpretation.

5. When a policy violation occurs, what are the necessary steps for the nurse manager? (EXCEPT)

• A. Describing the staff nurse's behavior that violated the policy
• B. Terminating the staff immediately
• C. Confrontation
• D. Determining the employee's awareness of the policy

Correct answer: B

Rationale: When a policy violation occurs, the necessary steps for the nurse manager include: describing the staff nurse's behavior that violated the policy, confrontation as a communication technique to address specific issues, and determining the employee's awareness of the policy. Terminating the employee immediately is not always the appropriate response to a policy violation, as there may be other corrective actions or interventions that can be taken to address the issue without resorting to termination. It is crucial to follow due process, provide guidance, and support to help employees understand and rectify their behavior.

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