Nursing Elites

1. How has advanced technology in health care, such as integrated health records, benefited nurses?

• A. Skip the assessment step of the nursing process
• B. Order medications
• C. Take blood samples
• D. Track patients' vital signs

Correct answer: D

Rationale: Advanced technology in health care, like integrated health records, has enabled nurses to efficiently track patients' vital signs. This capability helps nurses monitor patients' health status closely and make informed decisions regarding their care. Choices A, B, and C are incorrect because technology does not replace the vital role of nurses in conducting assessments, ordering medications (typically done by prescribers), or collecting blood samples.

2. An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?

• A. One or more of the parties may be able to reconcile their values.
• B. The patient�s point of view is recognized as valuable.
• C. The dilemma involves two or more equally unpleasant choices.
• D. The institution is unable to honor the patient�s request.

Correct answer: D

Rationale: A patient may make a request that is not possible within the institution. When this occurs, a solution may not be possible within the institution and the patient may need to be transferred to a different institution that may be able to honor the request.

3. A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?

• A. Perceived conflict
• B. Disruptive conflict
• C. Competitive conflict
• D. Felt conflict

Correct answer: B

Rationale: The correct answer is 'Disruptive conflict.' In disruptive conflict, the parties involved are engaged in activities to reduce, defeat, or eliminate the opponent. In this scenario, the resident and the nurse are engaging in behaviors that disrupt their professional relationship by intentionally ignoring pages and making excessive retaliatory calls. Perceived conflict refers to a situation where one or more parties believe that a conflict exists, competitive conflict involves striving to achieve personal goals at the expense of others, and felt conflict refers to the emotional involvement in a conflict situation.

4. One of the steps in coaching is often overlooked and taken for granted. What is this step?

• A. Stating the target
• B. Jumping to conclusions
• C. Asking for suggestions
• D. Tying the problem to clients' care

Correct answer: D

Rationale: In coaching, tying the problem to clients' care is crucial but often overlooked. This step ensures that the coach and the client focus on issues directly impacting the client's well-being. Stating the target (choice A) is important but not as critical as tying the problem to clients' care. Jumping to conclusions (choice B) is counterproductive in coaching as it may lead to incorrect assumptions. Asking for suggestions (choice C) is valuable, but it does not address the core aspect of linking the issue to the client's care, which is essential for effective coaching.

5. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?

• A. Teach the patient about administering regular insulin.
• B. Schedule the patient for a fasting blood glucose level.
• C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
• D. Provide teaching about an increased risk for fetal problems with gestational diabetes.

Correct answer: B

Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.

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