Nursing Elites

1. 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 RN should consider the ethical principle of confidentiality when replying.

2. An RN’s current patient and family have presented her with an ethical dilemma. What is the first step the RN should take to find a workable solution to the problem?

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

Correct answer: B

Rationale: The first step is assessment and identification of the problem.

3. 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.

4. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
• B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
• C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
• D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

5. Which of the following best describes the concept of patient-centered care?

• A. Care that is directed solely by healthcare providers
• B. Care that involves coordination among multiple healthcare providers
• C. Care that prioritizes the patient's preferences, needs, and values
• D. Care that strictly adheres to the latest clinical guidelines

Correct answer: C

Rationale: Patient-centered care is a healthcare approach that places the patient at the center of decision-making, emphasizing their preferences, needs, and values. This approach ensures that care is tailored to individual patients, taking into account their unique circumstances and actively involving them in their own care. Choice A is incorrect because patient-centered care focuses on the patient's needs rather than being solely directed by healthcare providers. Choice B is incorrect as involving multiple healthcare providers doesn't necessarily mean care is patient-centered; instead, it's about tailoring care to the patient's individual needs. Choice D is also incorrect as patient-centered care goes beyond just following clinical guidelines to encompass individual patient preferences and values.

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