Nursing Elites

1. A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?

• A. Infuse dextrose 50% by slow IV push.
• B. Administer 1 mg glucagon subcutaneously.
• C. Obtain a glucose reading using a finger stick.
• D. Have the patient drink 4 ounces of orange juice.

Correct answer: C

Rationale: The correct action for the nurse to take first when a patient reports feeling lightheaded and sweaty after being weaned off an insulin drip is to obtain a glucose reading using a finger stick. This will provide crucial information on the patient's current blood glucose level, helping the nurse assess if the symptoms are due to hypoglycemia. Based on the glucose reading, appropriate interventions can be initiated, such as administering dextrose, glucagon, or oral sugars like orange juice if hypoglycemia is confirmed. However, verifying the blood glucose level is the initial step to guide subsequent actions and ensure patient safety.

2. The Hawthorne effect explains that the relationship between people and productivity is enhanced by which of the following?

• A. Special attention
• B. Organizations
• C. Creativity
• D. Groups

Correct answer: A

Rationale: The Hawthorne effect is a term used to describe how people modify their behavior in response to the attention they are receiving rather than the manipulation of variables. Special attention, as mentioned in choice A, is the correct answer because when individuals feel that they are being closely monitored or that special interest is being taken in them, they tend to perform better or change their behavior. Choices B, C, and D are incorrect because the Hawthorne effect specifically focuses on the impact of attention and not on organizational structures, creativity, or group dynamics.

3. The ANA is a registered labor organization, but it does not engage in direct __________.

• A. Empower union affiliation
• B. Reward union affiliation
• C. Encourage union affiliation
• D. Collective bargaining

Correct answer: D

Rationale: The correct answer is D, 'Collective bargaining.' The American Nurses Association is a registered labor organization, but it does not engage in direct collective bargaining. The actual certification of units, negotiation of contracts, and administration of contracts is conducted by the state nurses associations (SNAs). Choices A, B, and C are incorrect as the ANA's role does not involve empowering, rewarding, or encouraging union affiliation directly.

4. After working at your job for 10 months and feeling unable to tolerate the tension and stress between staff nurses and the laissez-faire nurse manager who is not a leader, what is the best course of action?

• A. Submit a resignation and leave within 30 days.
• B. Complain to staff about the nurse manager.
• C. Seek another position within the healthcare organization and apply for a transfer.
• D. Inform the chief nursing officer that you are leaving and explain your dissatisfaction with the lack of leadership.

Correct answer: C

Rationale: In this situation, it is best to seek another position within the healthcare organization and apply for a transfer. Making professional decisions should involve careful evaluation and consideration. It is important to align personal values with the organizational culture. By seeking advice from a mentor or counselor, you can gain valuable insights and consider different perspectives. Resigning abruptly, complaining to staff, or informing the chief nursing officer without exploring other options may not be the most effective or professional approach in this scenario.

5. Which theory emphasizes the long-range plan rather than rewards?

• A. Equity theory.
• B. Development.
• C. Goal setting.
• D. Extinction.

Correct answer: C

Rationale: The correct answer is C, Goal setting. Goal-setting theory emphasizes that it is the goal itself that motivates a person to exert effort, not just the rewards or outcomes. This theory focuses on setting specific and challenging goals to enhance performance. Choices A, B, and D are incorrect because Equity theory relates to fairness in social exchanges, Development theory concerns personal growth and advancement, and Extinction refers to the disappearance of a behavior when it is no longer reinforced.

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