Nursing Elites

1. An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?

• A. Hemoglobin A1C level 6.2%
• B. Blood pressure 146/88 mmHg
• C. Heart rate at rest 58 beats/minute
• D. High-density lipoprotein (HDL) level 65 mg/dL

Correct answer: B

Rationale: The correct answer is B. In a young adult with type 1 diabetes, a blood pressure of 146/88 mmHg may indicate the need for a change in therapy as it is above the recommended target levels. High blood pressure can increase the risk of cardiovascular complications in diabetic patients. Choices A, C, and D are within normal ranges and do not necessarily indicate the need for an immediate change in therapy. A Hemoglobin A1C level of 6.2% is generally considered good control for a diabetic patient, a resting heart rate of 58 beats/minute is normal for an active individual, and an HDL level of 65 mg/dL is considered to be in the desirable range for heart health.

2. An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN�s friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying?

• A. Fidelity
• B. Confidentiality
• C. Veracity
• D. Accountability

Correct answer: B

Rationale: The principle of confidentiality requires nurses to hold healthcare information and anything patients tell them in the strictest confidence.

3. Achieving Magnet Hospital designation offers hospitals the following advantages: (Select one that does not apply.)

• A. Greater client satisfaction.
• B. Improved nursing recruitment.
• C. Greater client workload.
• D. Nurses who are independent decision makers.

Correct answer: C

Rationale: The correct answer is C. Achieving Magnet Hospital designation provides advantages such as greater client satisfaction, improved nursing recruitment, and nurses who are independent decision makers. However, the statement about 'Greater client workload' is not a typical advantage associated with Magnet recognition. Organizations that achieve Magnet recognition focus on improving nursing work environments, empowering nurses, and enhancing patient care quality, rather than increasing client workload. Therefore, C is the correct choice. Choices A, B, and D are incorrect because they align with the benefits of achieving Magnet Hospital designation as they lead to increased satisfaction, better recruitment, and more empowered nurses.

4. What is the main focus of health literacy initiatives?

• A. To promote the use of medical jargon
• B. To improve patient communication skills
• C. To ensure that patients understand their health information
• D. To reduce the use of electronic health records

Correct answer: C

Rationale: The main focus of health literacy initiatives is to ensure that patients understand their health information. By improving patient comprehension, individuals can make informed decisions about their health, leading to better health outcomes. Promoting the use of medical jargon would have the opposite effect, making health information less accessible. Improving patient communication skills is important but not the primary focus of health literacy initiatives. Electronic health records are tools for managing health information and not directly related to the main goal of health literacy initiatives.

5. 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.

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