Nursing Elites

1. A nurse recognizes which of the following as a primary goal of nursing?

• A. Assist patients to achieve a peaceful death.
• B. Improve personal knowledge and skills to enhance patient outcomes.
• C. Advocate for quality of life over the quantity of life.
• D. Work to control costs to enhance patients' quality of life.

Correct answer: A

Rationale: The correct answer is A: 'Assist patients to achieve a peaceful death.' One of the primary goals of nursing is to help patients experience a comfortable and peaceful passing when faced with terminal illness or at the end of life. This involves providing holistic care, managing symptoms, and ensuring that patients are as comfortable and pain-free as possible. Choices B, C, and D are incorrect because while improving knowledge and skills, advocating for quality of life, and controlling costs are important aspects of nursing care, they are not the primary goal related to end-of-life care.

2. When in opposition to an immediate superior, a nurse manager should use which important strategy in a confrontation?

• A. Using 'I' language
• B. Using absolutes
• C. Using 'why' questions
• D. Using negative assertions

Correct answer: A

Rationale: When in a confrontation, using 'I' language is crucial for a nurse manager. This approach allows the manager to express personal feelings without sounding accusatory, which can help reduce defensiveness and promote open communication. Choices B, C, and D are incorrect. Using absolutes can come off as rigid and may escalate the conflict. 'Why' questions can be perceived as confrontational and may put the other person on the defensive. Negative assertions can lead to a more hostile exchange rather than fostering a constructive dialogue.

3. A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about

• A. self-monitoring of blood glucose
• B. using low doses of regular insulin
• C. lifestyle changes to lower blood glucose
• D. effects of oral hypoglycemic medications

Correct answer: C

Rationale: When a patient has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L), indicating prediabetes, the initial approach is focused on lifestyle modifications to lower blood glucose levels. These changes may include dietary adjustments, increased physical activity, and weight management. Self-monitoring of blood glucose, insulin therapy, and oral hypoglycemic medications are not typically the first-line interventions for patients with prediabetes. Educating the patient about lifestyle changes to lower blood glucose is the most appropriate action at this stage.

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. A nurse is caring for a client who is scheduled to be transferred to a long-term care facility. The client's family questions the nurse about the reasons for the transfer. Which of the following responses made by the nurse is appropriate?

• A. The transfer of your family member is being done because the provider knows what's best.
• B. Would you like us to discuss the transfer with your family member?
• C. Why are you so concerned about this transfer?
• D. I know how you feel. My parent had to be transferred to a long-term care facility.

Correct answer: A

Rationale: The correct response is A because it provides a professional and reassuring explanation for the transfer, focusing on the expertise of the healthcare provider. Choice B offers to include the family member in the discussion, which may not address their concerns directly. Choice C appears defensive and does not address the family's inquiry. Choice D shifts the focus to the nurse's personal experience, which may not be relevant or helpful to the family seeking information about their own situation.

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