Nursing Elites

1. A nurse in a long-term care center notes that an employee is constantly calling in sick. Which action should the nurse take initially to handle this problem?

• A. Documenting the employee's absences in the personnel file
• B. Discussing the situation with the employee and reminding them of the agency's employment standards
• C. Reporting the employee to administration
• D. Issuing a written warning to the employee

Correct answer: B: Discussing the situation with the employee and reminding them of the agency's employment standards

Rationale: When an employee demonstrates excessive absenteeism, the initial action a nurse should take is to discuss the situation with the employee and remind them of the agency's employment standards. It is important to communicate openly with the employee to understand the reasons for their frequent absences and remind them of the expectations regarding attendance. This approach allows for a constructive dialogue and provides the employee with an opportunity to rectify their behavior. Documenting the employee's absences in the personnel file may be necessary if the issue persists despite the discussion. Reporting the employee to administration should be considered only if the employee fails to improve after the initial discussion. Issuing a written warning should be a subsequent step if the employee continues to violate the attendance policies even after reminders and discussions.

2. Which of the following is least important to test when assessing the client’s motor skills?

• A. strength
• B. knowledge of ergonomics
• C. balance
• D. coordination

Correct answer: B

Rationale: When assessing a client’s motor skills, it is crucial to evaluate their strength, balance, and coordination as these directly impact their motor abilities. Strength is essential to perform tasks, balance is required for stability, and coordination is necessary for smooth movements. However, knowledge of ergonomics, while beneficial for overall understanding, is not directly related to assessing motor skills. The focus should be on physical abilities rather than theoretical knowledge of ergonomics. Therefore, testing the client’s knowledge of ergonomics is the least important when evaluating their motor skills.

3. Which of the following lab values is associated with a decreased risk of cardiovascular disease?

• A. high HDL cholesterol
• B. low HDL cholesterol
• C. low total cholesterol
• D. low triglycerides

Correct answer: high HDL cholesterol

Rationale: High HDL cholesterol is associated with a decreased risk of cardiovascular disease because HDL cholesterol is known as 'good' cholesterol. It helps remove other forms of cholesterol, like LDL cholesterol, from the bloodstream, reducing the risk of plaque buildup in the arteries. Low HDL cholesterol (Choice B) is actually a risk factor for cardiovascular disease because it means there is less of the 'good' cholesterol to perform its protective functions. Low total cholesterol (Choice C) and low triglycerides (Choice D) are not necessarily associated with a decreased risk of cardiovascular disease, as the balance and types of cholesterol play a more crucial role in heart health.

4. A new nurse employed at a community hospital is reading the organization’s mission statement. The new nurse understands that this statement is written for which purpose?

• A. To outline what the organization plans to accomplish
• B. To identify the policies and procedures of the organization
• C. To describe the benefits available to employees
• D. To define the rules of the organization that the employees must follow

Correct answer: To outline what the organization plans to accomplish

Rationale: The correct answer is 'To outline what the organization plans to accomplish.' A mission statement expresses the purpose or reason for an organization's existence, outlining what it aims to achieve. It often includes statements of philosophy, purpose, and goals. This statement serves as a benchmark for evaluating the organization's performance. The mission statement is not meant to identify policies and procedures (Choice B) or describe employee benefits (Choice C). Choice B specifies the administrative guidelines and protocols of the organization, while Choice C pertains to the perks available to employees. Choice D is incorrect as the rules of the organization that employees must follow are usually detailed in employee handbooks or codes of conduct, not in the mission statement.

5. In which of the following conditions might increased cortisol levels be found?

• A. Cushing’s syndrome
• B. Addison’s disease
• C. Renal failure
• D. Congestive heart failure

Correct answer: Cushing’s syndrome

Rationale: Cushing’s syndrome is characterized by increased cortisol levels due to the overproduction of cortisol by the adrenal glands. This excess cortisol can lead to various symptoms and complications. Addison’s disease is associated with decreased cortisol levels as it results from adrenal insufficiency, making it an incorrect choice in this context. Renal failure and congestive heart failure are not typically linked to abnormal cortisol levels, further indicating that they are not the conditions where increased cortisol levels are found.

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