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. As a new nurse at a healthcare organization offering a nurse residency program, what would benefit you the most?

• A. Avoiding challenging patient assignments to minimize the risk of errors.
• B. Relying on your clinical preceptor, similar to your relationship with your nurse faculty.
• C. Establishing professional goals based on your clinical knowledge.
• D. Engaging in evidence-based practice projects immediately.

Correct answer: C

Rationale: As a new nurse joining a nurse residency program, the most beneficial action would be to establish professional goals based on your clinical knowledge. Setting clear goals allows you to focus on your learning needs, competency development, and guidance from your clinical preceptor. This proactive approach helps you maximize your learning opportunities, shape your professional growth, and enhance your skills as a novice nurse. Choice A is incorrect because avoiding challenging patient assignments may hinder your learning and skill development. Choice B is incorrect as while the clinical preceptor is essential, solely relying on them without personal professional goals may limit your growth. Choice D is incorrect because engaging in evidence-based practice projects immediately may be overwhelming for a new nurse without first establishing foundational goals.

3. How does decision making differ from problem solving?

• A. Decision making always involves selecting from a set of alternatives.
• B. Problem solving always involves selecting one of several alternatives.
• C. Problem solving never involves decision making.
• D. Decision making always involves solving a problem.

Correct answer: A

Rationale: The correct answer is A because decision making always involves selecting from a set of alternatives, while problem solving involves diagnosing a problem. Option B is incorrect as problem solving involves diagnosing a problem rather than selecting one of several alternatives. Option C is incorrect because decision making is often a part of problem-solving processes. Option D is incorrect as decision making may involve selecting from alternatives, not necessarily solving a problem.

4. The time period to give as notice for an appraisal is:

• A. One day.
• B. None.
• C. One week.
• D. Two days.

Correct answer: D

Rationale: The correct answer is D: 'Two days.' It is preferable to give two days' notice for a performance appraisal. Giving only one day's notice (Choice A) might not provide sufficient time for the employee to prepare adequately for the appraisal. Choice B, 'None,' is incorrect because it is essential to give advance notice for an appraisal to allow the employee time to get ready. Choice C, 'One week,' is too long of a notice period for a standard performance appraisal and could lead to unnecessary delays.

5. The changes brought forth by the state boards of nursing are an example of which type of change agent?

• A. Resistance
• B. Empirical–rational
• C. Normative–reeducative
• D. Power–coercive

Correct answer: D

Rationale: The changes implemented by state boards of nursing typically fall under the category of Power–coercive change agents. State boards of nursing have the authority to enforce changes through regulations and policies, making use of their legitimate power. Resistance (choice A) is not the correct answer as it refers to opposition to change rather than the entity driving change. Empirical–rational (choice B) focuses on convincing individuals through empirical evidence and rational arguments, which is not reflective of the state boards' authority. Normative–reeducative (choice C) involves persuading individuals to change based on shared values and beliefs, which is not the primary approach of state boards of nursing.

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