Nursing Elites

1. A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?

• A. ''I had a bowel movement, but I was able to save the urine.''
• B. ''I have a specimen in the bathroom from about 30 minutes ago.''
• C. ''I drink a lot, so I will fill up the bottle and complete the test quickly.''
• D. ''I flushed what I urinated at 7:00 a.m. and have saved all urine since.''

Correct answer: C

Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.

2. What is the focus of a continuous quality improvement program?

• A. Family
• B. Client
• C. Nurse
• D. Physician

Correct answer: B

Rationale: The correct answer is B: Client. Continuous quality improvement programs are primarily focused on improving services and outcomes for clients or patients. While families, nurses, and physicians are essential in healthcare, in the context of quality improvement, the main focus is on enhancing the experience and results for the clients receiving care. Choices A, C, and D are incorrect because they do not align with the primary goal of a continuous quality improvement program, which is to enhance client satisfaction, safety, and outcomes.

3. A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to

• A. check glucose levels before, during, and after swimming.
• B. delay eating the noon meal until after swimming.
• C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
• D. time the morning insulin injection so that the peak occurs while swimming.

Correct answer: A

Rationale: The correct answer is to teach the patient to check glucose levels before, during, and after swimming. This is important to monitor blood sugar levels and make adjustments as needed to prevent hypoglycemia or hyperglycemia. Delaying eating the noon meal until after swimming (Choice B) is not advisable as the patient needs proper nutrition both before and after exercise. Increasing the morning dose of NPH insulin (Choice C) should not be done without proper medical advice as it can lead to hypoglycemia. Timing the morning insulin injection to coincide with swimming (Choice D) is risky as the peak effect of insulin may lead to hypoglycemia during swimming.

4. Which of the following statements is true regarding nursing ethics?

• A. Nursing ethics focus on the organizational level at the workplace.
• B. Nursing ethics focus on the duties and rules of behavior for professional nurses.
• C. Nursing ethics focus on the moral character of nurses.
• D. Nursing ethics focus on the experiences and needs of nurses.

Correct answer: D

Rationale: Nursing ethics not only focus on the experiences and needs of nurses, but also on the nurses� perceptions of these experiences.

5. Which of the following types of leadership behaviors would be most useful when managing a staff of newly trained CNAs (Certified Nursing Assistants)?

• A. Achievement-oriented
• B. Supportive
• C. Participative
• D. Directive

Correct answer: D

Rationale: The most useful type of leadership behavior when managing a staff of newly trained CNAs (Certified Nursing Assistants) would be directive. Directive leadership involves giving specific guidance, ensuring adherence to rules and procedures, scheduling work efforts, and clearly telling employees what is expected. This approach is particularly beneficial for newly trained staff who may require clear instructions and guidance. - Achievement-oriented leadership focuses on setting challenging goals and encouraging employees to reach their highest potential. While this can be beneficial in some situations, it may not be the most suitable for managing newly trained CNAs who require more guidance and direction. - Supportive leadership involves providing emotional support, encouragement, and assistance to employees. While emotional support is essential in any work environment, newly trained CNAs may benefit more from clear direction and guidance. - Participative leadership involves involving employees in decision-making processes. While this can promote employee engagement and empowerment, newly trained CNAs may require more structured guidance and direction to ensure they understand their roles and responsibilities.

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