Nursing Elites

1. 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.

2. The decades between the 1960s and 1980s brought about many changes in nursing. Which of the following contributed to advances in nursing?

• A. Decreased demand for health care
• B. Development of specialty care disciplines
• C. Gender discrimination
• D. Advances in technology leading to more generalized care

Correct answer: B

Rationale: The correct answer is B because the development of specialty care disciplines, such as intensive care, neurosurgical techniques, and cardiothoracic surgery, played a significant role in advancing nursing during the specified decades. Choice A is incorrect as decreased demand for health care would not drive advances in nursing. Choice C is also incorrect as gender discrimination, while an issue in the past, does not directly relate to the advancements in nursing during this period. Choice D is incorrect because advances in technology usually lead to more specialized care rather than generalized care.

3. After change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

4. Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)?

• A. The patient�s blood glucose level is 174 mg/dL.
• B. The patient has gained 2 lb (0.9 kg) since yesterday.
• C. The patient is scheduled for a chest x-ray in an hour
• D. The patient�s blood urea nitrogen (BUN) level is 52 mg/dL.

Correct answer: D

Rationale:

5. Which of the following best describes the concept of total quality management (TQM)?

• A. Top-down management
• B. Employee-centered approach
• C. Continuous improvement
• D. Quality control

Correct answer: C

Rationale: The correct answer is C: Continuous improvement. Total quality management (TQM) focuses on continuously improving all aspects of healthcare delivery to enhance patient care, safety, and overall quality. Choice A, 'Top-down management,' does not capture the essence of TQM, which involves involvement at all levels of an organization. Choice B, 'Employee-centered approach,' while important, is not the defining characteristic of TQM. Choice D, 'Quality control,' is a component of TQM but does not fully encompass its comprehensive approach to quality improvement.

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