Nursing Elites

1. As a nurse manager rounds on the unit, he speaks with staff, patients, and family members. Later in the day, he is in a meeting with administration. During the conversations, he considers how these interactions impact the care provided to patients on the unit. Which of the following interpersonal activities best describes this manager’s actions?

• A. Networking
• B. Employee development
• C. Coaching
• D. Monitoring

Correct answer: A

Rationale: The correct answer is 'Networking.' Networking involves building relationships and connecting with staff, patients, and family members to establish a supportive network. In this scenario, the nurse manager is engaging in networking by interacting with various individuals to understand how these interactions influence patient care. 'Employee development' involves activities aimed at enhancing employees' skills and knowledge. 'Coaching' focuses on guiding individuals to improve performance, while 'Monitoring' involves overseeing and supervising activities to ensure compliance and quality.

2. Knowing that gluconeogenesis helps to maintain blood glucose levels, a healthcare provider should:

• A. Document weight changes due to fatty acid mobilization.
• B. Evaluate the patient's sensitivity to low room temperatures due to decreased adipose tissue insulation.
• C. Protect the patient from sources of infection due to decreased cellular protein deposits.
• D. Do all of the above.

Correct answer: D

Rationale: Gluconeogenesis is a process where the body synthesizes glucose from non-carbohydrate sources to maintain blood glucose levels. Documenting weight changes due to fatty acid mobilization is important as it can impact the patient's metabolic status. Evaluating the patient's sensitivity to low room temperatures because of decreased adipose tissue insulation is crucial to prevent hypothermia. Protecting the patient from sources of infection due to decreased cellular protein deposits is essential to prevent complications. Therefore, all the options are relevant considerations in managing a patient undergoing gluconeogenesis, making option D the correct answer.

3. The nurse is caring for a client with a history of adrenal insufficiency. The nurse should monitor for which of the following signs of an Addisonian crisis?

• A. Hypertension
• B. Hyperglycemia
• C. Severe hypotension
• D. Tachycardia

Correct answer: C

Rationale: In an Addisonian crisis, there is a lack of adrenal hormones leading to severe hypotension. Hypertension (choice A) is not a typical sign of Addisonian crisis but can occur in conditions like pheochromocytoma. Hyperglycemia (choice B) is not a characteristic sign of an Addisonian crisis. Tachycardia (choice D) may occur as a compensatory mechanism in response to hypotension, but severe bradycardia is more common in an Addisonian crisis.

4. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following clinical manifestations should the nurse expect?

• A. Hypernatremia
• B. Hypotension
• C. Decreased urine output
• D. Polyuria

Correct answer: C

Rationale: The correct answer is C: 'Decreased urine output.' Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive release of antidiuretic hormone, leading to water retention and decreased urine output. Therefore, the nurse should expect the client to have decreased urine output. Choices A, B, and D are incorrect. Hypernatremia (Choice A) is not typically associated with SIADH as it usually leads to dilutional hyponatremia. Hypotension (Choice B) is not a common clinical manifestation of SIADH. Polyuria (Choice D) is the opposite of what is expected in a client with SIADH, who typically presents with decreased urine output.

5. A nurse manager works hard to keep employee morale high with the thought that this will lead to effective employees doing the best work they can. Which of the following theories does this best describe?

• A. Theory X
• B. Theory Y
• C. Servant leadership
• D. Scientific management

Correct answer: B

Rationale: Theory Y, as proposed by Douglas McGregor, emphasizes that employees are intrinsically motivated and seek responsibility. It suggests that high morale leads to high productivity, aligning with the nurse manager's actions. Theory X, on the other hand, assumes employees are inherently lazy and need to be closely monitored and controlled. Servant leadership focuses on serving others first and prioritizing their needs, which is not directly related to the scenario described. Scientific management, developed by Frederick Taylor, emphasizes efficiency and standardization through systematic study and organizational control, which is not the primary focus of the nurse manager's approach to boosting employee morale.

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