Nursing Elites

1. Most evaluations are based on absolute judgment. This is:

• A. A standard set by an external source.
• B. The manager and staff's perceived notion.
• C. Internal standards.
• D. The manager's personal opinion.

Correct answer: C

Rationale: The internal standard used in evaluations is the criteria set by the manager, reflecting what they perceive as reasonable and acceptable performance for the employee. Choice A is incorrect because the standard is internal, not set by an external source. Choice B is incorrect as it refers to the collective perception of the manager and staff, rather than the internal standard. Choice D is incorrect as it refers to the manager's personal opinion, which may not always align with the internal standards set for evaluations.

2. The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes. Which question is most appropriate for the nurse to ask?

• A. "Are you anorexic?"
• B. "Is your urine dark colored?"
• C. "Have you lost weight lately?"
• D. "Do you crave sugary drinks?"

Correct answer: C

Rationale: Weight loss is a common symptom in the onset of type 1 diabetes due to the body's inability to use glucose for energy. The lack of insulin leads the body to break down fat and muscle for fuel, causing unintentional weight loss. This is a more relevant question compared to the others, as it directly relates to the metabolic changes associated with type 1 diabetes.

3. What quality is observed among individuals who strive to find the best way to do their job?

• A. Punctuality
• B. Strictness
• C. Honesty
• D. Motivation

Correct answer: D

Rationale: Motivation is the driving force that compels individuals to strive to find the best way to do their job. It encompasses determination, enthusiasm, and a proactive approach to continuously improve and excel in their work. Being motivated is essential for individuals in any profession to seek innovative solutions, achieve excellence, and make a meaningful impact. Punctuality, while important, refers to being on time rather than the drive to find the best way to do a job. Strictness relates to enforcing rules or discipline, not necessarily to seeking the best way. Honesty is about truthfulness and integrity, which are crucial but not directly related to the pursuit of excellence in job performance.

4. What is the process of helping an employee to improve performance called?

• A. Coaching
• B. Disciplining
• C. Mentoring
• D. Peer reviewing

Correct answer: A

Rationale: The correct answer is A: Coaching. Coaching involves providing guidance and support to help an employee enhance their performance by focusing on skill development, addressing weaknesses, and achieving professional growth. Mentoring (choice C) is about guiding and nurturing a less experienced individual, not specifically aimed at improving performance. Peer reviewing (choice D) involves colleagues evaluating each other's performance, not necessarily focused on improvement. Disciplining (choice B) is taking corrective actions in response to policy violations or performance issues, which is different from the process of helping an employee improve their performance.

5. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

• A. use only the lispro insulin until the symptoms are resolved
• B. limit calorie intake until the glucose is less than 120 mg/dL
• C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
• D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%

Correct answer: C

Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.

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