Nursing Elites

1. The Hawthorne effect explains that the relationship between people and productivity is enhanced by which of the following?

• A. Special attention
• B. Organizations
• C. Creativity
• D. Groups

Correct answer: A

Rationale: The Hawthorne effect is a term used to describe how people modify their behavior in response to the attention they are receiving rather than the manipulation of variables. Special attention, as mentioned in choice A, is the correct answer because when individuals feel that they are being closely monitored or that special interest is being taken in them, they tend to perform better or change their behavior. Choices B, C, and D are incorrect because the Hawthorne effect specifically focuses on the impact of attention and not on organizational structures, creativity, or group dynamics.

2. An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?

• A. One or more of the parties may be able to reconcile their values.
• B. The patient�s point of view is recognized as valuable.
• C. The dilemma involves two or more equally unpleasant choices.
• D. The institution is unable to honor the patient�s request.

Correct answer: C

Rationale: An agreement cannot be reached because the dilemma involves two or more equally unpleasant choices.

3. 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.

4. A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to

• A. save the lunch tray for the patient�s later return to the unit
• B. ask that diagnostic testing area staff to start a 5% dextrose IV
• C. send a glass of milk or orange juice to the patient in the diagnostic testing area
• D. request that if testing is further delayed, the patient be returned to the unit to eat.

Correct answer: D

Rationale:

5. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

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