Nursing Elites

1. Which statement to a patient newly diagnosed with type 2 diabetes is correct?

• A. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
• B. Insulin is not used to control blood glucose in patients with type 2 diabetes.
• C. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
• D. Type 2 diabetes is usually diagnosed when the patient is admitted with a hyperglycemic coma.

Correct answer: C

Rationale: Choice C is the correct statement to convey to a patient newly diagnosed with type 2 diabetes. Lifestyle modifications, such as changes in diet and exercise, are essential components of managing type 2 diabetes. These changes can help control blood glucose levels and improve overall health. Options A, B, and D are incorrect statements. While complications of type 2 diabetes can be serious, they are different from those of type 1 diabetes. Some patients with type 2 diabetes may require insulin therapy, but it is not true that insulin is not used at all. Type 2 diabetes is not typically diagnosed during a hyperglycemic coma, as it is usually identified through routine screenings or symptoms unrelated to a coma.

2. 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: 'Your timely response to patients' call lights is exemplary.' This choice reflects a positive reinforcement approach, providing feedback that praises and encourages good behavior. A coach in a professional setting aims to motivate, guide, and support staff rather than focusing on negative aspects or threats of discipline. Effective coaching involves recognizing and acknowledging employees' strengths and achievements to inspire continuous improvement and development. Choices B, C, and D are not examples of coaching as they either focus on criticism regarding appearance, use threatening language, or highlight a negative behavior without offering guidance or support.

3. Which of the following behaviors would be an early warning sign that you are not handling job stress in a healthy way?

• A. Focusing excessively on patient outcomes
• B. Needing to spend more time alone
• C. Juggling work, studies, and family responsibilities
• D. Awakening in the morning feeling unrested

Correct answer: D

Rationale: The correct answer is D. Awakening in the morning feeling unrested can be an early warning sign that you are not handling job stress in a healthy way. This may indicate that the stress is impacting your quality of sleep, which is essential for managing stress and maintaining overall well-being. Choices A, B, and C are not necessarily indicative of unhealthy stress management. Focusing excessively on patient outcomes may show dedication to work, needing to spend more time alone could be a personal preference, and juggling work, studies, and family responsibilities could be a common challenge that many individuals face.

4. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

5. When lifting a bedside cabinet to move it closer to a client, what action should the nurse take to prevent self-injury?

• A. Keep the feet close together.
• B. Use the back muscles for lifting.
• C. Stand close to the cabinet when lifting it.
• D. Bend at the waist.

Correct answer: A

Rationale: The correct answer is A: 'Keep the feet close together.' When lifting a heavy object such as a bedside cabinet, it is essential to maintain a wide base of support by keeping the feet close together. This provides better stability and reduces the risk of injury. Choice B is incorrect because using the back muscles for lifting can lead to back strain and injury; it is recommended to use the legs instead. Choice C is incorrect as standing close to the cabinet may cause the nurse to lose balance and strain the back. Choice D is incorrect because bending at the waist increases the risk of back injury. Therefore, the safest and most appropriate action is to keep the feet close together to ensure stability and prevent self-injury.

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