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. After correcting the IVF infusion rate, what should be the next step in the client's care?

• A. Notify family
• B. Discipline the previous nurse
• C. Complete an incident report
• D. Obtain legal consultation

Correct answer: C

Rationale: The correct next step in the client's care after correcting the IVF infusion rate is to complete an incident report. This report is crucial for documenting the event, identifying the root cause of the error, and implementing measures to prevent similar incidents in the future. Notifying the family, disciplining the previous nurse, and obtaining legal consultation are not immediate priorities in this situation. Family notification may be necessary later but ensuring patient safety and proper documentation come first. Disciplining the previous nurse should be handled through the appropriate professional channels, not as an immediate response to the incident. Legal consultation may be needed in some cases but is not the initial step required after correcting the error and ensuring the client's safety.

3. A new nurse manager is attempting to solve a management issue by using one solution after another until she solves the problem. This would be known as what type of method?

• A. Decision making
• B. Trial and error
• C. Experimentation
• D. Analysis

Correct answer: B

Rationale: The correct answer is B. Trial and error is a method used by new managers to solve problems by trying different solutions until one is successful. In this scenario, the nurse manager is using a trial and error approach by attempting various solutions until the issue is resolved. Choices A, C, and D are incorrect because decision making involves making choices based on available information, experimentation involves testing hypotheses in a controlled setting, and analysis entails examining data and information to gain insights or draw conclusions, none of which directly reflect the iterative process of trial and error.

4. What is the primary focus of a performance appraisal for nursing staff?

• A. To identify areas for salary increases
• B. To evaluate overall job performance
• C. To provide feedback on clinical skills
• D. To determine eligibility for promotions

Correct answer: C

Rationale: The primary focus of a performance appraisal for nursing staff is to provide feedback on clinical skills, identify areas for improvement, and support professional development. While salary increases, overall job performance evaluation, and promotions may be factors considered during a performance appraisal, the primary goal is to assess and enhance clinical skills to ensure high-quality patient care.

5. As a new graduate employed in a high-volume maternity unit that uses differentiated practice as its staffing model, what can the nurse expect?

• A. Evidence-based practice guides risk management principles.
• B. Client teaching is the responsibility of the team leader.
• C. The initial level of practice responsibility will be limited.
• D. Seniority is the main determinant of client assignments.

Correct answer: C

Rationale: In a differentiated practice model, the scope of nursing practice and responsibility are tailored to different levels of experience. As a new graduate with limited experience, the nurse can expect that the initial level of practice responsibility will be limited to match their skill level and knowledge. This allows for a gradual increase in responsibilities as the nurse gains more experience and expertise. Choice A is incorrect because evidence-based practice is related to clinical decision-making, not the staffing model. Choice B is incorrect as client teaching is typically a shared responsibility among the healthcare team, not solely the team leader's. Choice D is incorrect as differentiated practice models focus on skill level and competence rather than seniority when determining client assignments.

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