Nursing Elites

1. A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to

• A. check glucose levels before, during, and after swimming.
• B. delay eating the noon meal until after swimming.
• C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
• D. time the morning insulin injection so that the peak occurs while swimming.

Correct answer: A

Rationale: The correct answer is to teach the patient to check glucose levels before, during, and after swimming. This is important to monitor blood sugar levels and make adjustments as needed to prevent hypoglycemia or hyperglycemia. Delaying eating the noon meal until after swimming (Choice B) is not advisable as the patient needs proper nutrition both before and after exercise. Increasing the morning dose of NPH insulin (Choice C) should not be done without proper medical advice as it can lead to hypoglycemia. Timing the morning insulin injection to coincide with swimming (Choice D) is risky as the peak effect of insulin may lead to hypoglycemia during swimming.

2. Although technology has seen many advances, which two ethical principles may be in conflict because of technology?

• A. Beneficence and justice
• B. Beneficence and nonmaleficence
• C. Beneficence and veracity
• D. Beneficence and confidentiality

Correct answer: B

Rationale: The correct answer is B: Beneficence and nonmaleficence. Beneficence is the ethical principle of doing good to benefit others, while nonmaleficence is the principle of doing no harm to others. With technological advances, there can be a conflict between these two principles, as the benefits of technology may inadvertently cause harm, leading to an ethical dilemma. Choices A, C, and D are incorrect because while beneficence is involved in all options, the conflicting principle of nonmaleficence specifically addresses the avoidance of harm, making it the most relevant in the context of technology's impact on ethical principles.

3. When planning to run for the local school board, which of the following sources of power would a nurse find important?

• A. Connection
• B. Reward
• C. Charisma
• D. Expertise

Correct answer: A

Rationale: When a nurse is planning to run for the local school board, the important source of power would be 'Connection.' In politics, building relationships and forming connections are crucial for gaining support, forming coalitions, and accessing valuable information. Being charismatic is not a necessary attribute for utilizing power effectively in this context. While expertise is valuable, especially in education-related matters, it is not specified as a primary source of power for a political candidate. Rewards are not typically within the purview of a candidate running for a position such as the local school board.

4. What is the primary focus of health promotion activities?

• A. To manage chronic diseases
• B. To educate patients about their health
• C. To prevent the onset of disease
• D. To identify and treat diseases early

Correct answer: C

Rationale: The correct answer is C: 'To prevent the onset of disease.' Health promotion activities aim to prevent diseases before they occur by promoting healthy behaviors, lifestyles, and environments. Choice A, 'To manage chronic diseases,' is incorrect as health promotion focuses on prevention rather than management. Choice B, 'To educate patients about their health,' is important but not the primary focus of health promotion. Choice D, 'To identify and treat diseases early,' is related to early detection and treatment, which is different from the primary goal of health promotion.

5. A registered nurse (RN) administered a patient�s morning insulin as the breakfast tray arrived at 0800. The RN performed a complete assessment at the same time. Then, the RN got busy with her other patients and did not check on the patient until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. Which of the following could the RN be charged with?

• A. Quasi-intentional tort
• B. Misdemeanor
• C. Negligence
• D. Juvenile offense

Correct answer: C

Rationale: Negligence is the failure to act in a reasonable, ordinary, and prudent manner, causing harm to someone who is owed the duty to care.

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