Nursing Elites

1. A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about

• A. self-monitoring of blood glucose
• B. using low doses of regular insulin
• C. lifestyle changes to lower blood glucose
• D. effects of oral hypoglycemic medications

Correct answer: C

Rationale: When a patient has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L), indicating prediabetes, the initial approach is focused on lifestyle modifications to lower blood glucose levels. These changes may include dietary adjustments, increased physical activity, and weight management. Self-monitoring of blood glucose, insulin therapy, and oral hypoglycemic medications are not typically the first-line interventions for patients with prediabetes. Educating the patient about lifestyle changes to lower blood glucose is the most appropriate action at this stage.

2. Which of the following is an example of a conflict of interest in nursing?

• A. A nurse accepting gifts from a patient
• B. A nurse working for two competing healthcare organizations
• C. A nurse disclosing patient information without consent
• D. A nurse delegating tasks improperly

Correct answer: B

Rationale: The correct answer is B. A nurse working for two competing healthcare organizations represents a conflict of interest as it may affect impartiality. Choice A is incorrect as accepting gifts from a patient may be a violation of ethical standards, but it is not a conflict of interest. Choice C is incorrect as disclosing patient information without consent is a breach of confidentiality, not a conflict of interest. Choice D is incorrect as delegating tasks improperly relates to professional competence, not a conflict of interest.

3. Which of the following would be considered an urgent and important issue?

• A. Replacing two staff who were injured while caring for a violent patient
• B. Updating the employee break room with new furniture
• C. Preparing educational packets on self-administration of insulin for patients
• D. Arranging a team-building event for staff members

Correct answer: A

Rationale: The correct answer is A because replacing staff injured while caring for a violent patient is both urgent and important. This issue directly relates to staff safety and patient care, requiring immediate attention. Choice B is not urgent or crucial to patient care. Choice C is important but may not be as urgent as the situation in choice A. Choice D is not as critical as replacing injured staff, making it a less urgent and important issue.

4. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.

5. A client experiences an air emboli, resulting in a stroke, during an IV start. This can be classified as which type of risk?

• A. Patient dissatisfaction
• B. Medical-legal incident
• C. Medication error
• D. Diagnostic procedure

Correct answer: D

Rationale: The correct answer is D, 'Diagnostic procedure.' When a client experiences an air emboli leading to a stroke during an IV start, it falls under the category of a diagnostic procedure risk. This incident occurred during a procedure intended for diagnosis or evaluation. Choices A, B, and C are incorrect. Patient dissatisfaction refers to a client's discontent with care, service, or outcomes; a medical-legal incident involves legal issues related to healthcare practices; and a medication error pertains to mistakes in medication administration.

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