Nursing Elites

1. What is typically the first sign that a healthcare professional with a substance abuse problem will exhibit?

• A. Avoidance
• B. Bargaining
• C. Denial
• D. Regression

Correct answer: C

Rationale: The correct answer is C: Denial. When healthcare professionals have substance abuse problems, denial is often the initial sign they exhibit. Denial involves minimizing or refusing to acknowledge the issue, making it difficult to recognize and address the substance abuse problem. Choices A, B, and D are incorrect. Avoidance, bargaining, and regression are not typically the first signs displayed by healthcare professionals with substance abuse problems. By identifying denial early on, healthcare professionals can take the necessary steps to seek help and overcome substance abuse issues.

2. A Nurse Manager completes an interruption log and identifies two staff members who take an inordinate amount of time with drop-in issues that are not urgent. What are some methods to address this behavior in an attempt to better manage time? (Select all that apply.)

• A. Designate specific time slots for drop-in visits.
• B. Position the desk chair so it is not facing the hallway.
• C. Communicate with staff about using e-mail for non-urgent matters to improve time management.
• D. When staff members drop in, the manager should stand and remain standing during the conversation.

Correct answer: A

Rationale: Designating specific time slots for drop-in visits helps in managing interruptions effectively by consolidating them into designated periods. This approach allows the Nurse Manager to allocate focused time for addressing these issues without disrupting workflow. Option B, repositioning the desk chair, is not a standard strategy for managing time or interruptions. Option C, promoting the use of e-mail for non-urgent matters, may help in some cases but may not entirely address the behavior of extended drop-in visits. Option D, standing during conversations, may not be practical for longer discussions and does not provide a structured approach to address time management issues.

3. Professionalism has historically been difficult to define. Early definitions of professionalism included which of the following characteristics?

• A. Expertise
• B. Empathy
• C. Ethical and moral values
• D. Honesty

Correct answer: A

Rationale: The correct answer is A: 'Expertise.' Historically, professionalism was defined by one's knowledge and expertise in a particular field. Choices B, C, and D are incorrect because early definitions of professionalism did not focus on qualities like empathy, ethical and moral values, or honesty, but rather on the individual's level of skill and competence in their area of work.

4. After receiving change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who has a hemoglobin A1C of 12%
• B. 23-year-old with type 1 diabetes who has a blood glucose of 40 mg/dL
• C. 40-year-old who is pregnant and has an oral glucose tolerance test result of 202 mg/dL
• D. 50-year-old who uses exenatide (Byetta) and is complaining of acute abdominal pain

Correct answer: B

Rationale: The correct answer is B because the patient with a blood glucose level of 40 mg/dL (hypoglycemia) needs immediate attention. Hypoglycemia is an emergency situation that requires prompt intervention to prevent adverse effects such as seizures or loss of consciousness. Assessing and managing this patient first is crucial to prevent further deterioration. Choices A, C, and D do not present immediate life-threatening situations requiring urgent intervention like severe hypoglycemia does. While a high hemoglobin A1C level (choice A), an abnormal oral glucose tolerance test result (choice C), and acute abdominal pain (choice D) are important issues, they do not pose an immediate threat to the patient's life compared to severe hypoglycemia.

5. Which of the following is the correct definition of 'chain of command'?

• A. The hierarchy of authority and responsibility
• B. Relationship without authority
• C. Activity directed through linear authority
• D. The tendency for people to perform as expected

Correct answer: A

Rationale: The correct definition of 'chain of command' is the hierarchy of authority and responsibility. This term refers to the order in which authority and power in an organization are wielded and delegated from top management to every employee at every level. Choice B, 'Relationship without authority,' is incorrect because the chain of command specifically involves authority and responsibility. Choice C, 'Activity directed through linear authority,' is not a precise definition of the chain of command, as it does not encompass the full scope of authority and hierarchy. Choice D, 'The tendency for people to perform as expected,' is unrelated to the concept of the chain of command.

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