Nursing Elites

1. The ANA recommends that nursing in the health care organization change its focus. This requires a shift from a technical model to which of the following?

• A. Professional
• B. Industrial
• C. Random
• D. Organized

Correct answer: A

Rationale: The correct answer is A: Professional. The American Nurses Association (ANA) recommends shifting the focus in healthcare organizations from a technical model to a professional model. This change emphasizes the level of nurse competence required to provide quality care. Choice B, Industrial, is incorrect as it does not align with the focus on professionalism in nursing. Choice C, Random, is unrelated to the context of the question. Choice D, Organized, while a positive attribute, is not the specific focus recommended by the ANA for nursing in healthcare organizations.

2. 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.

3. When matching a job with an experienced RN, what is the first step in the selection process?

• A. Job analysis
• B. Selection techniques
• C. Methods of recruiting
• D. Assurance of legal requirements

Correct answer: A

Rationale: The correct answer is A, job analysis. Job analysis is the first step in the selection process as it involves gathering information about the duties, responsibilities, necessary skills, outcomes, and work environment of a particular job. This information is crucial in creating an accurate job description and specification that will guide the recruitment and selection process. Choices B, C, and D are incorrect because while selection techniques, methods of recruiting, and legal requirements are important aspects of the selection process, they come after the job analysis has been completed.

4. A nurse recognizes which of the following as a primary goal of nursing?

• A. Assist patients to achieve a peaceful death.
• B. Improve personal knowledge and skills to enhance patient outcomes.
• C. Advocate for quality of life rather than quantity of life.
• D. Work to control costs to enhance patients' quality of life.

Correct answer: A

Rationale: The primary goal of nursing is to promote health, prevent illness, alleviate suffering, and care for the sick. Assisting patients to achieve a peaceful death is an essential aspect of nursing care, ensuring dignity and comfort in the end-of-life phase. While improving personal knowledge and advocating for quality of life are important aspects of nursing, the primary goal remains the well-being and comfort of patients, even in death. Working to control costs, while a consideration in healthcare, is not the primary goal of nursing, which is centered on patient care and well-being.

5. Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)?

• A. Glyburide decreases glucagon secretion from the pancreas.
• B. Glyburide stimulates insulin production and release from the pancreas.
• C. Glyburide should be taken even if the morning blood glucose level is low.
• D. Glyburide should not be used for 48 hours after receiving IV contrast media.

Correct answer: B

Rationale: The correct answer is B: Glyburide stimulates insulin production and release from the pancreas. Glyburide belongs to the sulfonylurea class of antidiabetic medications, which work by stimulating the pancreas to produce and release more insulin. This helps to lower blood glucose levels. Choice A is incorrect because glyburide does not decrease glucagon secretion; instead, it acts on insulin. Choice C is incorrect because taking glyburide when blood glucose is low can lead to hypoglycemia. Choice D is incorrect as there is no specific interaction between glyburide and IV contrast media that requires avoiding its use for 48 hours.

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