Nursing Elites

1. Successful professional nurses benefit from working with mentors. What mutually rewarding outcomes are realized in mentoring relationships? (EXCEPT)

• A. Instilling a sense of accomplishing a meaningful effort
• B. Assuming each other's characteristics
• C. Fostering an interdependent relationship
• D. Promoting self-esteem

Correct answer: B

Rationale: Professional nurses who seek mentoring relationships work with their mentors to gain objective feedback, guidance, and confidence. A mentoring relationship is critical when making job decisions, establishing goals, discussing professional judgment, considering ethical issues, and in determining challenges for growth. Choice B, "Assuming each other's characteristics," is incorrect because mentoring is about learning, guidance, and support to develop one's own professional identity, not about assuming someone else's characteristics. Choices A, C, and D are all beneficial outcomes of mentoring relationships, including instilling a sense of accomplishment, fostering interdependence, and promoting self-esteem, respectively.

2. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

3. To best reduce the potential for risk, what type of atmosphere is needed to be developed?

• A. Nurse-focused
• B. Physician-focused
• C. Family-focused
• D. Patient-focused

Correct answer: D

Rationale: The correct answer is 'Patient-focused.' When aiming to reduce the potential for risk, it is essential to prioritize the needs and well-being of the patients. Creating a patient-focused atmosphere helps ensure that decisions and actions are made with the patients' best interests in mind. Choices A, B, and C are incorrect because while nurses, physicians, and families play essential roles in healthcare, when it comes to reducing risks, the primary focus should be on the patients themselves.

4. A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to

• A. check glucose levels before, during, and after swimming.
• B. delay eating the noon meal until after swimming.
• C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
• D. time the morning insulin injection so that the peak occurs while swimming.

Correct answer: A

Rationale: The correct answer is to teach the patient to check glucose levels before, during, and after swimming. This is important to monitor blood sugar levels and make adjustments as needed to prevent hypoglycemia or hyperglycemia. Delaying eating the noon meal until after swimming (Choice B) is not advisable as the patient needs proper nutrition both before and after exercise. Increasing the morning dose of NPH insulin (Choice C) should not be done without proper medical advice as it can lead to hypoglycemia. Timing the morning insulin injection to coincide with swimming (Choice D) is risky as the peak effect of insulin may lead to hypoglycemia during swimming.

5. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution’s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: Incompetence jeopardizes patient safety. Therefore, the formal process for handling these practices should be followed.

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