Nursing Elites

1. 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 the RN should take to find a workable solution to the problem is assessment.

2. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

• A. Avoid snacking at bedtime.
• B. Increase the rapid-acting insulin dose.
• C. Check the blood glucose during the night.
• D. Administer a larger dose of long-acting insulin.

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

3. Which of the following statements is true regarding nursing ethics?

• A. Nursing ethics focus on the organizational level at the workplace.
• B. Nursing ethics focus on the duties and rules of behavior for professional nurses.
• C. Nursing ethics focus on the moral character of nurses.
• D. Nursing ethics focus on the experiences and needs of nurses.

Correct answer: D

Rationale: Nursing ethics not only focus on the experiences and needs of nurses, but also on the nurses� perceptions of these experiences.

4. What is the role of a nurse in a multidisciplinary team (MDT)?

• A. To lead the MDT
• B. To provide emotional support
• C. To advocate for patient needs
• D. To conduct clinical research

Correct answer: C

Rationale: In a multidisciplinary team (MDT), a nurse's role is to advocate for patient needs and ensure their perspectives are considered in the care plan. While leadership may be a part of a nurse's role in some settings, the primary focus in an MDT is collaboration and coordination. Providing emotional support is essential but may not be the primary role of a nurse in an MDT. Conducting clinical research is typically not a direct responsibility of a nurse in an MDT focused on patient care.

5. A nurse manager wants to implement a new policy on the unit. What is the first step in the change process according to Lewin's Change Theory?

• A. Unfreeze the system
• B. Move the system to a new level
• C. Refreeze the system
• D. Evaluate the system

Correct answer: A

Rationale: The correct answer is A: 'Unfreeze the system.' According to Lewin's Change Theory, unfreezing the system is the initial step in the change process. This step involves preparing the organization for change by creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Choice B, 'Move the system to a new level,' is incorrect as it does not align with the first step of unfreezing. Choice C, 'Refreeze the system,' is incorrect as it pertains to the final stage of solidifying the change, not the first step. Choice D, 'Evaluate the system,' is incorrect as evaluation typically occurs after the change has been implemented, not at the beginning of the change process.

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