Nursing Elites

1. A nurse manager conducts evaluations with each staff member and reviews the staffing needs for the upcoming year. Which of the following best describes the behavior this manager is engaging in?

• A. Interpersonal activities
• B. Decisional activities
• C. Informational activities
• D. Transformational activities

Correct answer: B

Rationale: The correct answer is B: Decisional activities. A nurse manager conducting evaluations and reviewing staffing needs for the future involves making decisions related to resource allocation, planning, and problem-solving. These activities fall under the category of decisional activities in management. Choice A, Interpersonal activities, would involve activities like communicating, motivating, and leading staff. Choice C, Informational activities, would involve activities like gathering and disseminating information. Choice D, Transformational activities, would involve inspiring and motivating staff to achieve organizational goals through vision and change.

2. Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following except:

• A. Integumentary inspection for the presence of brown spots on the lower extremities.
• B. Observation for paleness of the lower extremities.
• C. Observation for blanching of the feet after the legs are elevated for 60 seconds.
• D. Palpation for increased pulse volume in the arteries of the lower extremities.

Correct answer: D

Rationale: In a patient with impaired peripheral arterial circulation, clinical nursing assessment should include integumentary inspection for the presence of brown spots, observation for paleness of the lower extremities, and observation for blanching of the feet after the legs are elevated for 60 seconds. Palpation for increased pulse volume in the arteries of the lower extremities is not consistent with impaired circulation, as pulses are typically diminished in this condition. Therefore, palpation for increased pulse volume is not relevant to the assessment of impaired peripheral arterial circulation.

3. A client with type 2 diabetes mellitus is being educated on foot care. Which of the following instructions should the nurse provide?

• A. Soak your feet in warm water daily.
• B. Avoid going barefoot to protect your feet.
• C. Inspect your feet daily for any cuts or sores.
• D. Avoid using a heating pad to warm your feet if they are cold.

Correct answer: C

Rationale: The correct instruction for a client with type 2 diabetes mellitus regarding foot care is to inspect their feet daily for any cuts or sores. This practice helps in early detection of potential issues like cuts, sores, or infections, which can be challenging to heal due to poor circulation in diabetes. Choice A is incorrect because soaking feet in hot water can lead to burns or skin damage, especially for individuals with diabetes who may have reduced sensation. Choice B is incorrect because going barefoot increases the risk of injuries and infections for individuals with diabetes. Choice D is incorrect because using a heating pad can also impair sensation, increasing the risk of burns or injuries for diabetic individuals.

4. A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client:

• A. Prefers to take insulin orally.
• B. Has type 2 diabetes.
• C. Has type 1 diabetes.
• D. Is pregnant and has type 2 diabetes.

Correct answer: B

Rationale: Oral antidiabetic agents are specifically designed for type 2 diabetes mellitus. Type 1 diabetes requires insulin therapy as the primary treatment due to the absence of endogenous insulin production. Therefore, these medications are not effective for individuals with type 1 diabetes like the male client in this scenario. Choice A is incorrect as oral antidiabetic agents are not about preference but rather about treatment efficacy. Choice D is incorrect as being pregnant does not impact the effectiveness of oral antidiabetic agents; they are primarily indicated for type 2 diabetes.

5. Nurse Troy is aware that the most appropriate nursing diagnosis for a client with Addison's disease is:

• A. Risk for infection
• B. Excessive fluid volume
• C. Urinary retention
• D. Hypothermia

Correct answer: A

Rationale: The most appropriate nursing diagnosis for a client with Addison's disease is 'Risk for infection.' Addison's disease is characterized by corticosteroid deficiency, which leads to immune suppression, making these clients more susceptible to infections. This diagnosis reflects the increased vulnerability of clients with Addison's disease to infections. Choices B, C, and D are incorrect because Addison's disease does not typically present with excessive fluid volume, urinary retention, or hypothermia as primary concerns.

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