Nursing Elites

1. The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia) through a restricted access medication program. What is most important for the nurse to report immediately to the health care provider?

• A. The patient's blood pressure is 154/92.
• B. The patient has a history of emphysema
• C. The patient's blood glucose is 86 mg/dL.
• D. The patient has chest pressure when walking

Correct answer: D

Rationale: Chest pressure while walking may indicate heart-related issues such as angina or a heart attack. Rosiglitazone (Avandia) has been associated with increased risks of cardiovascular events like heart failure. Given these risks, chest pressure is an urgent symptom that must be reported immediately to prevent potentially life-threatening complications.

2. Strategies to advance your career and opportunities available in your first job can coexist. Identify factors that will help you prioritize these opportunities to fulfill your goals. (Select all that apply.)

• A. Self-actualization and assessing your values and your lifestyle.
• B. Determine where you can grow and develop professionally.
• C. Your ability to work as a team member.
• D. Reflect on your long-term career aspirations.

Correct answer: A

Rationale: The correct answer is A. Self-actualization involves assessing your values and lifestyle, which is crucial for prioritizing opportunities that align with your goals. This process helps you understand yourself better and make informed decisions to advance your career. Choice B is incorrect because focusing solely on salary may not necessarily lead to career growth and fulfillment. Choice C is about teamwork skills, which are important but not directly related to prioritizing career opportunities. Choice D is about seeking opinions from others, which may not always align with your personal goals and aspirations.

3. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

4. When should the nurse initiate discharge planning for a client experiencing an exacerbation of heart failure?

• A. During the admission process
• B. As soon as the client's condition is stable
• C. After consulting with the client's family
• D. During the initial team conference

Correct answer: B

Rationale: The correct time for the nurse to initiate discharge planning for a client experiencing an exacerbation of heart failure is as soon as the client's condition is stable. Discharge planning should begin early to ensure a smooth transition and continuity of care. While involving the client's family in the planning process is crucial, the primary focus should be on starting the preparations for discharge once the client's immediate health concerns are addressed and their condition is stable. Waiting for a team conference or after consulting with the family may delay the planning process, which is not ideal in ensuring a timely and effective discharge plan.

5. A nurse manager is using the nominal group technique to gather input from the staff on a new policy. What is the primary method of exchange in this technique?

• A. Oral presentations
• B. Email exchanges
• C. Written reports
• D. Group discussions

Correct answer: C

Rationale: In the nominal group technique, the primary method of exchange is through written reports. Participants independently generate ideas in writing, which are then shared and discussed within the group. This structured process allows for equal participation and prevents dominant individuals from influencing the group's outcome. Oral presentations (choice A) involve speaking rather than written communication, making it less suitable for the nominal group technique. Email exchanges (choice B) are also not the primary method as they lack the structured approach of the nominal group technique. Group discussions (choice D) do occur in the nominal group technique but are secondary to the initial written idea generation phase.

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