Nursing Elites

1. 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 because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

2. Which of the following best describes the concept of evidence-based management?

• A. Using personal experience to make managerial decisions
• B. Combining managerial expertise with the latest research evidence
• C. Using intuition and experience to guide management decisions
• D. Relying on peer-reviewed literature to inform management practices

Correct answer: B

Rationale: The concept of evidence-based management involves combining managerial expertise with the latest research evidence to make informed decisions. Choice A is incorrect because relying solely on personal experience may not align with the best available evidence. Choice C is incorrect as it emphasizes intuition over research evidence. Choice D is incorrect because evidence-based management involves not only peer-reviewed literature but also incorporating managerial expertise.

3. An RN comes upon a serious motor vehicle accident that has just occurred and no first responders are on the scene. One car has been flipped upside down, and she can see the driver still in the car. The RN decides to stop and help. She knows she is protected from civil liability as long as she does which of the following?

• A. Acts in an ordinary, reasonable, and prudent professional manner
• B. Assures that information obtained is not communicated to anyone else
• C. Does not make any verbal comments that could lead to economic harm
• D. Fails to meet the established standards of practice

Correct answer: A

Rationale: The correct answer is A: 'Acts in an ordinary, reasonable, and prudent professional manner.' In emergency situations, healthcare professionals are protected from civil liability as long as they act in a manner that any other reasonable and prudent professional would under similar circumstances. Choice B is incorrect because communication of relevant information is essential for patient care and handover to other healthcare providers. Choice C is incorrect as it pertains to a different issue of preventing economic harm rather than addressing the immediate medical needs of the injured driver. Choice D is incorrect because failing to meet established standards of practice can lead to liability, especially in emergencies where immediate action is required to save lives.

4. A unit manager has been working to decrease the incidence of catheter-associated urinary tract infections on his unit, spending extra time on the unit researching best practices and conducting training. Having completed training, the manager decides to take a couple of days off. Which of the following leadership traits is this unit manager displaying?

• A. Perseverance
• B. Balance
• C. Generosity
• D. Ability to handle stress

Correct answer: B

Rationale: The correct answer is 'Balance.' The unit manager is displaying balance by recognizing the importance of taking time off to rest and recharge after working diligently to decrease infections. 'Perseverance' is not the correct choice because the manager is taking time off, not persisting in the face of challenges. 'Generosity' and 'Ability to handle stress' are also incorrect as they do not align with the situation described.

5. A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?

• A. Suction the client's airway.
• B. Instruct the client to perform incentive spirometry every hour.
• C. Assist the client to an upright position.
• D. Humidify the client's supplemental oxygen.

Correct answer: C

Rationale: When a client is experiencing difficulty breathing, the priority intervention is to assist the client to an upright position. This position helps improve ventilation by maximizing lung expansion and promoting better oxygenation. Suctioning the airway may be necessary if there is an obstruction, but repositioning the client is the initial step. Instructing the client to perform incentive spirometry and humidifying oxygen are important interventions but not the first priority in this scenario.

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