Nursing Elites

1. The new graduate nurse interviews for a position in a nursing department of a large health care agency, described by the interviewer as having shared governance. Which of these statements best illustrates the shared governance model?

• A. An appointed board oversees any administrative decisions
• B. Nursing departments share responsibility for client outcomes
• C. Staff groups are appointed to discuss nursing practice and client education issues
• D. Non-nurse managers supervise nursing staff in groups of units

Correct answer: B

Rationale: The correct answer is B because shared governance involves nurses and other staff sharing responsibility for decisions related to patient care and outcomes, promoting collaborative practice and shared accountability. Choice A is incorrect as shared governance includes active participation of frontline staff, not just an appointed board. Choice C is incorrect because shared governance goes beyond just discussing issues to actively sharing responsibility for decision-making. Choice D is incorrect as shared governance encourages nurses to have a significant role in decision-making rather than being supervised by non-nurse managers.

2. Which of these tests with frequency would the nurse expect to monitor for the evaluation of clients with poor glycemic control in persons aged 18 and older?

• A. A glycosylated hemoglobin (A1c) should be performed during an initial assessment and during follow-up assessments, which should occur at no longer than 3-month intervals
• B. A glycosylated hemoglobin should be obtained at least twice a year
• C. A fasting glucose and a glycosylated hemoglobin should be obtained at 3-month intervals after the initial assessment
• D. A glucose tolerance test, a fasting glucose, and a glycosylated hemoglobin should be obtained at 6-month intervals after the initial assessment

Correct answer: A

Rationale: Glycosylated hemoglobin (A1c) testing every 3 months is recommended for clients with poor glycemic control to monitor their average blood sugar levels and adjust treatment as necessary. Choice A is correct as it aligns with the guideline of performing A1c testing every 3 months. Choice B is incorrect because testing at least twice a year may not provide adequate monitoring for clients with poor glycemic control. Choice C is incorrect as it only mentions testing at 3-month intervals without specifying the importance of A1c testing. Choice D is incorrect as it includes unnecessary tests like glucose tolerance test and does not emphasize the importance of more frequent A1c monitoring for clients with poor glycemic control.

3. An example of the continuum health model of health and wellness would be:

• A. a person is either well or not, and the emphasis is on continuously and aggressively treating people who are ill
• B. predicting that a person will most likely continue good health practices, based on his or her health practices in the past, such as getting flu shots
• C. using acupuncture and therapeutic touch to cure disease instead of traditional medical therapies
• D. none of the above

Correct answer: B

Rationale: The continuum health model emphasizes ongoing health practices based on past behaviors. Choice A is incorrect as it describes a more binary approach to health. Choice C is incorrect as it focuses on alternative therapies rather than the continuity of health practices.

4. While assessing a client in an outpatient facility with a panic disorder, the nurse completes a thorough health history and physical exam. Which finding is most significant for this client?

• A. Compulsive behavior
• B. Sense of impending doom
• C. Fear of flying
• D. Predictable episodes

Correct answer: B

Rationale: The correct answer is B: 'Sense of impending doom.' In panic disorder, a sense of impending doom is a hallmark symptom often experienced by clients. This intense feeling of dread or fear is a key feature of panic attacks. Compulsive behavior (choice A) may be more indicative of obsessive-compulsive disorder rather than panic disorder. Fear of flying (choice C) may be more related to specific phobias rather than panic disorder. Predictable episodes (choice D) do not align with the unpredictable nature of panic attacks.

5. The nurse should consider the following when assessing the child for chest indrawing EXCEPT:

• A. Chest indrawing should be present at all times
• B. The lower chest wall does not go in when the child breathes in
• C. The lower chest goes in when the child breathes in
• D. The child should be calm

Correct answer: A

Rationale: The correct answer is A. Chest indrawing may not always be present and can vary with the child's activity level, so it should not be expected to be present at all times. Choice B is correct because the lower chest wall should not go in when the child breathes in. Choice C is correct as the lower chest should go in when the child breathes in, indicating chest indrawing. Choice D is correct as a calm child makes it easier to assess chest indrawing, but the absence of chest indrawing does not mean the child is not calm.

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