Nursing Elites

1. Penalties should be __________ .

• A. Determining the employee's awareness of the policy
• B. Describing the staff nurse's behavior that violated the policy
• C. Progressive
• D. Confrontation

Correct answer: C

Rationale: Penalties for policy violations should be progressive. This means that the disciplinary actions should escalate based on the severity or frequency of the violation. For minor infractions, like smoking in an unauthorized area, a progressive approach may include oral warnings, written warnings, suspension, and termination if the behavior persists. In contrast, major violations, such as theft, may warrant immediate and severe consequences like suspension or termination. Choices A, B, and D are incorrect as they do not address the concept of progressively escalating penalties based on the violation's severity or recurrence.

2. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?

• A. Measure the ankle-brachial index.
• B. Check for changes in skin pigmentation.
• C. Assess for unilateral or bilateral foot drop.
• D. Ask the patient about symptoms of depression.

Correct answer: A

Rationale: The correct answer is A: Measure the ankle-brachial index. This task involves using a Doppler ultrasound device to assess blood flow, which can be safely delegated to UAP. Choices B, C, and D require a higher level of assessment and interpretation that should be performed by licensed nursing staff. Checking for changes in skin pigmentation (B) and assessing for foot drop (C) involve more complex assessments that require nursing judgment. Asking about symptoms of depression (D) involves a psychosocial assessment, which should be performed by licensed personnel qualified to address mental health concerns.

3. The staff nurse is experiencing what type of conflict when the babysitter calls to cancel on the day of an important committee meeting?

• A. Intergroup conflict
• B. Perceived conflict
• C. Role conflict
• D. Structural conflict

Correct answer: C

Rationale: The correct answer is C: Role conflict. Role conflict arises when one has conflicting responsibilities or obligations, such as being scheduled to work while also needing to care for children. In this scenario, the staff nurse faces a conflict between their role as a parent needing childcare and their role as a professional scheduled to present at a committee meeting. Intergroup conflict (A) involves disputes between different groups, not conflicting roles within an individual. Structural conflict (D) stems from issues within the organizational structure, not conflicting responsibilities. Perceived conflict (B) refers to misunderstandings or misinterpretations between parties, not conflicting roles.

4. A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following statements should the nurse identify as an indication that the client understands the preoperative teaching they received about pain management?

• A. ''I think I should take my pain medication more often, since it is not controlling my pain.''
• B. ''Breathing faster will help me keep my mind off of the pain.''
• C. ''It might help me to listen to music while I'm lying in bed.''
• D. ''I don't want to walk today because I have some pain.''

Correct answer: D

Rationale: The correct answer is D because the client is demonstrating an understanding of the preoperative teaching by acknowledging the pain and relating it to the need to rest. Walking may exacerbate the pain, and the client's decision not to walk shows an awareness of their body's signals. Choices A, B, and C are incorrect as they do not reflect a good understanding of pain management. Choice A suggests self-medicating without consulting healthcare providers, choice B focuses on distraction rather than addressing the pain, and choice C offers a coping mechanism but does not address the pain directly.

5. The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which patient statement indicates a need for additional teaching?

• A. �If I overeat at a meal, I will still take the usual dose of medication.�
• B. �Other medications besides the Glucotrol may affect my blood sugar.�
• C. �When I am ill, I may have to take insulin to control my blood sugar.�
• D. �My diabetes won�t cause complications because I don�t need insulin.�

Correct answer: D

Rationale:

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