Nursing Elites

1. The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose

• A. washes the puncture site using warm water and soap
• B. chooses a puncture site in the center of the finger pad
• C. hangs the arm down for a minute before puncturing the site
• D. says the result of 120 mg indicates good blood sugar control

Correct answer: B

Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad is not recommended for blood glucose monitoring. The recommended sites are the sides of the fingertips. Option A is correct as washing the puncture site using warm water and soap is a good practice. Option C is also correct as hanging the arm down for a minute can help increase blood flow. Option D is incorrect as a blood sugar level of 120 mg/dL may not necessarily indicate good blood sugar control and needs further interpretation.

2. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

3. Successful professional nurses benefit from working with mentors. What mutually rewarding outcomes are realized in mentoring relationships? (EXCEPT)

• A. Instilling a sense of accomplishing a meaningful effort
• B. Assuming each other's characteristics
• C. Fostering an interdependent relationship
• D. Promoting self-esteem

Correct answer: B

Rationale: Professional nurses who seek mentoring relationships work with their mentors to gain objective feedback, guidance, and confidence. A mentoring relationship is critical when making job decisions, establishing goals, discussing professional judgment, considering ethical issues, and in determining challenges for growth. Choice B, "Assuming each other's characteristics," is incorrect because mentoring is about learning, guidance, and support to develop one's own professional identity, not about assuming someone else's characteristics. Choices A, C, and D are all beneficial outcomes of mentoring relationships, including instilling a sense of accomplishment, fostering interdependence, and promoting self-esteem, respectively.

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

• A. 19-year-old with type 1 diabetes who has a hemoglobin A1C of 12%
• B. 23-year-old with type 1 diabetes who has a blood glucose of 40 mg/dL
• C. 40-year-old who is pregnant and has an oral glucose tolerance test result of 202 mg/dL
• D. 50-year-old who uses exenatide (Byetta) and is complaining of acute abdominal pain

Correct answer: B

Rationale: The correct answer is B because the patient with a blood glucose level of 40 mg/dL (hypoglycemia) needs immediate attention. Hypoglycemia is an emergency situation that requires prompt intervention to prevent adverse effects such as seizures or loss of consciousness. Assessing and managing this patient first is crucial to prevent further deterioration. Choices A, C, and D do not present immediate life-threatening situations requiring urgent intervention like severe hypoglycemia does. While a high hemoglobin A1C level (choice A), an abnormal oral glucose tolerance test result (choice C), and acute abdominal pain (choice D) are important issues, they do not pose an immediate threat to the patient's life compared to severe hypoglycemia.

5. A nurse supervisor is planning an educational session for her staff regarding improving teamwork among different generations. Which of the following recommendations will reduce potential generational conflicts?

• A. Involve only millennials in technology decisions.
• B. Focus on the team as a whole, rather than individual generations.
• C. Involve only the baby boomers in technology decisions.
• D. Practice active and assertive communication techniques.

Correct answer: D

Rationale: Active and assertive communication will assist each generation to value the others� skills and perspectives.

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