Nursing Elites

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

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

2. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision-makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the ethical decision-making process, after identifying the decision-makers involved, the next step is typically planning. During the planning stage, the RN will consider the available options, weigh the ethical principles involved, and develop a course of action to address the ethical dilemma. Choice A, Assessment, involves gathering information and data about the situation. Choice B, Diagnosis, involves analyzing the gathered information to identify the ethical issue. Choice D, Implementation, comes after planning and involves putting the chosen course of action into practice.

3. A manager is working on the personnel budget for the year. The manager anticipates needing to replace 832 benefit hours. How many FTEs (Full-Time Equivalents) will be needed for replacement?

• A. 0.40 FTEs
• B. 17.0 FTEs
• C. 0.05 FTEs
• D. 1.0 FTEs

Correct answer: A

Rationale: To calculate the number of Full-Time Equivalents (FTEs) needed for replacement, divide the number of benefit hours (832) by the standard number of hours in a full-time work year (2,080). Therefore, 832 benefit hours ÷ 2,080 = 0.4 FTEs, which is equivalent to 0.40 FTEs. Choice B (17.0 FTEs) is incorrect as it is a significantly high number that does not align with the calculation. Choice C (0.05 FTEs) is incorrect because it is too low for the given number of benefit hours. Choice D (1.0 FTEs) is incorrect as it represents a full-time position, which is not the correct calculation for replacing 832 benefit hours.

4. If a task is delegated to someone, they need to be granted the ___________ to complete the task.

• A. Authority
• B. Planning
• C. Organizing
• D. Controlling

Correct answer: A

Rationale: Correct Answer: Authority When a task is delegated, it is essential to grant the individual the authority to complete it. Authority refers to the power or right to give commands, make decisions, and enforce obedience. Planning (choice B), organizing (choice C), and controlling (choice D) are important aspects of management but do not directly address the need for authorization to carry out a delegated task.

5. While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.

• A. Parallel
• B. Functional
• C. Service-integrated
• D. Matrix

Correct answer: B

Rationale: The correct answer is B: Functional. In functional structures, employees are grouped into departments based on specialty, allowing individuals with similar skills and tasks to work together efficiently. In this scenario, organizing the hospital into departments such as nursing, dietary, and pharmacy based on their specialties exemplifies a functional organizational structure. Choice A, Parallel structure, involves independent units working on similar tasks, which is not the case here. Choice C, Service-integrated structure, emphasizes cross-functional teamwork across various departments, which is not the main focus in the scenario. Choice D, Matrix structure, involves employees reporting to multiple managers for different projects or tasks, which is not described in the scenario.

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