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. An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?

• A. One or more of the parties may be able to reconcile their values.
• B. The patient�s point of view is recognized as valuable.
• C. The dilemma involves two or more equally unpleasant choices.
• D. The institution is unable to honor the patient�s request.

Correct answer: C

Rationale: An agreement cannot be reached because the dilemma involves two or more equally unpleasant choices.

3. Which of the following is a key component of a successful quality improvement (QI) project?

• A. Standardized care protocols
• B. Employee satisfaction
• C. Ongoing training and education
• D. Financial incentives

Correct answer: C

Rationale: Ongoing training and education is the correct answer as it is an essential component of a successful quality improvement project. Continuous training and education help ensure that staff are knowledgeable about and up-to-date with the latest practices, technologies, and methodologies in healthcare. This ongoing learning process contributes to improving the quality of care provided.\nChoice A, standardized care protocols, though important, is more about ensuring consistency in care delivery rather than driving quality improvement initiatives. Choice B, employee satisfaction, while significant for staff morale, is not directly related to the core processes of quality improvement projects. Choice D, financial incentives, although motivating, are not the primary driver for successful quality improvement projects; it is the knowledge and skills gained through training and education that play a more critical role in enhancing quality.

4. When communicating with a client who has a complaint, what principle is important to keep in mind?

• A. Supervisors should always be involved.
• B. The client's physician is often the cause of the problem.
• C. Avoid discussion of complaints.
• D. Clients and families should be treated with respect; communication should be open and honest.

Correct answer: D

Rationale: When addressing complaints from clients, it is crucial to prioritize treating clients and families with respect. Open and honest communication fosters trust and transparency in resolving issues effectively. This client-centered approach emphasizes the importance of maintaining positive relationships within the healthcare setting. Choices A, B, and C are incorrect. Involving supervisors in every communication with a client who has a complaint may not always be necessary or practical. Blaming the client's physician for the issue is unprofessional and does not address the client's concerns. Avoiding discussion of complaints can lead to unresolved issues and dissatisfaction among clients.

5. What is the primary focus of Lean methodology in healthcare?

• A. Reduce healthcare costs
• B. Enhance patient satisfaction
• C. Increase patient throughput
• D. Standardize care processes

Correct answer: D

Rationale: The correct answer is D: Standardize care processes. Lean methodology in healthcare focuses on standardizing care processes to improve efficiency and reduce waste. While reducing healthcare costs and enhancing patient satisfaction are important goals in healthcare, the primary focus of Lean methodology is to standardize care processes to ensure consistent, high-quality care delivery. Increasing patient throughput may be a byproduct of implementing Lean principles but is not the primary focus.

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