Nursing Elites

1. An RN’s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN’s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: A DNR order can be written after the health-care provider has discussed it with the client and family.

2. When communicating with a client who has a complaint, what principle is important to keep in mind?

• A. Supervisors should always be involved.
• B. The client's physician is often the cause of the problem.
• C. Avoid discussion of complaints.
• D. Clients and families should be treated with respect; communication should be open and honest.

Correct answer: D

Rationale: When addressing complaints from clients, it is crucial to prioritize treating clients and families with respect. Open and honest communication fosters trust and transparency in resolving issues effectively. This client-centered approach emphasizes the importance of maintaining positive relationships within the healthcare setting. Choices A, B, and C are incorrect. Involving supervisors in every communication with a client who has a complaint may not always be necessary or practical. Blaming the client's physician for the issue is unprofessional and does not address the client's concerns. Avoiding discussion of complaints can lead to unresolved issues and dissatisfaction among clients.

3. The nurse manager is talking with the CNA about her time management. Which of the following is an example of a nurse manager as a coach?

• A. Your timely response to patients' call lights is exemplary.
• B. Your appearance is seldom professional.
• C. You must get the vital signs taken on time or you will be disciplined.
• D. You never report AM blood sugar levels on time.

Correct answer: A

Rationale: The correct answer is A: 'Your timely response to patients' call lights is exemplary.' This choice reflects a positive reinforcement approach, providing feedback that praises and encourages good behavior. A coach in a professional setting aims to motivate, guide, and support staff rather than focusing on negative aspects or threats of discipline. Effective coaching involves recognizing and acknowledging employees' strengths and achievements to inspire continuous improvement and development. Choices B, C, and D are not examples of coaching as they either focus on criticism regarding appearance, use threatening language, or highlight a negative behavior without offering guidance or support.

4. A nurse manager is preparing to review medication documentation with a group of newly licensed nurses. Which of the following statements should the nurse manager plan to include in the teaching?

• A. Use the complete name of the medication magnesium sulfate.
• B. Delete the space between the numerical dose and the unit of measure.
• C. Use the abbreviation SC when indicating a subcutaneous injection.
• D. Write the letter U when noting the dosage of insulin.

Correct answer: C

Rationale: The correct statement that the nurse manager should include in the teaching session is to use the abbreviation SC when indicating a subcutaneous injection. This is important for accurate and standardized medication documentation. Choice A is incorrect because using the complete name of medications is not always necessary and may lead to errors. Choice B is incorrect as spaces between dose and unit of measure are required for clarity and to avoid misinterpretation. Choice D is incorrect because the standard abbreviation for units should be used instead of the letter U to prevent confusion.

5. 1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?

• A. Blood pressure
• B. Serum creatinine
• C. Chest x-ray
• D. Urine for microalbuminuria

Correct answer: C

Rationale: The correct answer is C: Chest x-ray. While monitoring for complications in a patient with type 2 diabetes, annual tests such as blood pressure measurement, serum creatinine levels, and urine for microalbuminuria are essential. These tests help in assessing kidney function, cardiovascular health, and early signs of kidney damage, which are common complications of diabetes. A chest x-ray is not routinely scheduled annually to monitor for complications related to type 2 diabetes, making it the least applicable option.

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