Nursing Elites

1. What is the primary focus of transitional care?

• A. To improve clinical outcomes
• B. To manage chronic diseases
• C. To facilitate smooth transitions between care settings
• D. To support family caregivers

Correct answer: C

Rationale: The primary focus of transitional care is to facilitate smooth transitions between care settings. While improving clinical outcomes and managing chronic diseases are important aspects of healthcare, the main goal of transitional care is to ensure patients move smoothly between different care settings such as hospitals, rehabilitation centers, and home care. Supporting family caregivers is also essential but not the primary focus of transitional care.

2. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

3. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

• A. Avoid snacking at bedtime.
• B. Increase the rapid-acting insulin dose.
• C. Check the blood glucose during the night.
• D. Administer a larger dose of long-acting insulin.

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

4. Which of the following is a potential benefit of social media?

• A. Sharing the fun side of nursing by posting a video of nurses singing and dancing in the hallways of the hospital while on duty
• B. Connecting with clients to keep up with their health status
• C. Connecting with the public to encourage healthy behaviors
• D. Sharing pictures of interesting clinical experiences with friends

Correct answer: C

Rationale: The correct answer is C because connecting with the public to encourage healthy behaviors is a significant benefit of social media. It allows for the dissemination of valuable health information, promoting healthy habits, and raising awareness about important health issues. Choices A, B, and D are not as impactful as choice C in terms of promoting public health and healthy behaviors. Choice A focuses more on entertainment rather than health promotion, choice B is specific to client connections rather than public health initiatives, and choice D is more about sharing experiences rather than encouraging healthy behaviors.

5. A nurse manager wants to implement a new policy on the unit. What is the first step in the change process according to Lewin's Change Theory?

• A. Unfreeze the system
• B. Move the system to a new level
• C. Refreeze the system
• D. Evaluate the system

Correct answer: A

Rationale: The correct answer is A: 'Unfreeze the system.' According to Lewin's Change Theory, unfreezing the system is the initial step in the change process. This step involves preparing the organization for change by creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Choice B, 'Move the system to a new level,' is incorrect as it does not align with the first step of unfreezing. Choice C, 'Refreeze the system,' is incorrect as it pertains to the final stage of solidifying the change, not the first step. Choice D, 'Evaluate the system,' is incorrect as evaluation typically occurs after the change has been implemented, not at the beginning of the change process.

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