Nursing Elites

1. There are many ways to ensure that your appraisal system is nondiscriminatory. Which of the following is one way to ensure this?

• A. Giving the appraisal once per year
• B. Having no appeal process
• C. Withholding information from the employee
• D. Not allowing any input from the employee

Correct answer: A

Rationale: To ensure that an appraisal system is nondiscriminatory, one important step is to provide the appraisal once per year. This allows for ongoing evaluation and helps prevent bias. Choice B is incorrect because having no appeal process can lead to unfair treatment without a chance for review. Choice C is incorrect as withholding information from the employee can hinder transparency and objectivity. Choice D is incorrect as not allowing any input from the employee can overlook valuable insights and perspectives that could contribute to a fair evaluation process.

2. Which of the following is a primary responsibility of a nurse case manager?

• A. Direct patient care
• B. Financial planning
• C. Conduct health education
• D. Coordinate patient transitions

Correct answer: D

Rationale: A primary responsibility of a nurse case manager is to coordinate patient transitions. This involves ensuring smooth transitions between healthcare settings, coordinating care plans, and ensuring continuity of care for patients. While direct patient care, financial planning, and health education are important aspects of healthcare, they are not primary responsibilities of a nurse case manager. Nurse case managers focus on managing and coordinating the overall care and services for patients.

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

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

4. The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes. Which question is most appropriate for the nurse to ask?

• A. "Are you anorexic?"
• B. "Is your urine dark colored?"
• C. "Have you lost weight lately?"
• D. "Do you crave sugary drinks?"

Correct answer: C

Rationale: Weight loss is a common symptom in the onset of type 1 diabetes due to the body's inability to use glucose for energy. The lack of insulin leads the body to break down fat and muscle for fuel, causing unintentional weight loss. This is a more relevant question compared to the others, as it directly relates to the metabolic changes associated with type 1 diabetes.

5. When planning to run for the local school board, which of the following sources of power would a nurse find important?

• A. Connection
• B. Reward
• C. Charisma
• D. Expertise

Correct answer: A

Rationale: When a nurse is planning to run for the local school board, the important source of power would be 'Connection.' In politics, building relationships and forming connections are crucial for gaining support, forming coalitions, and accessing valuable information. Being charismatic is not a necessary attribute for utilizing power effectively in this context. While expertise is valuable, especially in education-related matters, it is not specified as a primary source of power for a political candidate. Rewards are not typically within the purview of a candidate running for a position such as the local school board.

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