Nursing Elites

1. The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?

• A. “I can have an occasional alcoholic drink if I include it in my meal plan.”
• B. “I will need a bedtime snack because I take an evening dose of NPH insulin.”
• C. “I can choose any foods, as long as I use enough insulin to cover the calories.”
• D. “I will eat something at meal times to prevent hypoglycemia, even if I am not hungry.”

Correct answer: C

Rationale:

2. Which of the following strategies is most effective for reducing medication errors on a nursing unit?

• A. Increasing the nurse-to-patient ratio
• B. Providing ongoing education on safe medication practices
• C. Using barcoding technology for medication administration
• D. Increasing the use of PRN medications

Correct answer: C

Rationale: The most effective strategy for reducing medication errors on a nursing unit is using barcoding technology for medication administration. Barcoding technology helps to ensure the right medication is given to the right patient in the right dose at the right time. Increasing the nurse-to-patient ratio (choice A) may help in preventing errors due to workload, but it may not address the root cause of medication errors. Providing ongoing education (choice B) is important but may not be as effective as implementing technology to directly prevent errors during administration. Increasing the use of PRN medications (choice D) can actually increase the risk of errors if not carefully monitored and controlled.

3. The changes brought forth by the state boards of nursing are an example of which type of change agent?

• A. Resistance
• B. Empirical–rational
• C. Normative–reeducative
• D. Power–coercive

Correct answer: D

Rationale: The changes implemented by state boards of nursing typically fall under the category of Power–coercive change agents. State boards of nursing have the authority to enforce changes through regulations and policies, making use of their legitimate power. Resistance (choice A) is not the correct answer as it refers to opposition to change rather than the entity driving change. Empirical–rational (choice B) focuses on convincing individuals through empirical evidence and rational arguments, which is not reflective of the state boards' authority. Normative–reeducative (choice C) involves persuading individuals to change based on shared values and beliefs, which is not the primary approach of state boards of nursing.

4. What is the focus of a continuous quality improvement program?

• A. Family
• B. Client
• C. Nurse
• D. Physician

Correct answer: B

Rationale: The correct answer is B: Client. Continuous quality improvement programs are primarily focused on improving services and outcomes for clients or patients. While families, nurses, and physicians are essential in healthcare, in the context of quality improvement, the main focus is on enhancing the experience and results for the clients receiving care. Choices A, C, and D are incorrect because they do not align with the primary goal of a continuous quality improvement program, which is to enhance client satisfaction, safety, and outcomes.

5. When a policy violation occurs, what are the necessary steps for the nurse manager? (EXCEPT)

• A. Describing the staff nurse's behavior that violated the policy
• B. Terminating the staff immediately
• C. Confrontation
• D. Determining the employee's awareness of the policy

Correct answer: B

Rationale: When a policy violation occurs, the necessary steps for the nurse manager include: describing the staff nurse's behavior that violated the policy, confrontation as a communication technique to address specific issues, and determining the employee's awareness of the policy. Terminating the employee immediately is not always the appropriate response to a policy violation, as there may be other corrective actions or interventions that can be taken to address the issue without resorting to termination. It is crucial to follow due process, provide guidance, and support to help employees understand and rectify their behavior.

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