Nursing Elites

1. When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the healthcare provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may

• A. require administration of insulin while taking prednisone
• B. develop acute hypoglycemia while taking prednisone
• C. require administration of insulin while taking prednisone
• D. have rashes caused by metformin-prednisone interactions

Correct answer: C

Rationale: When a patient taking metformin develops an allergic rash from an unknown cause and is prescribed prednisone, the nurse should anticipate that the patient may require administration of insulin while taking prednisone. Prednisone can increase blood glucose levels by antagonizing the effects of insulin, leading to hyperglycemia. Therefore, the patient may need additional insulin to manage blood sugar levels effectively. The other options are incorrect as prednisone would not directly cause a need for a higher-calorie diet, acute hypoglycemia, or rashes caused by a metformin-prednisone interaction.

2. Employees are eligible to take a leave of absence if they have worked for the employer for at least: (EXCEPT)

• A. At least 1,250 hours during the previous 12 months.
• B. At least 12 months.
• C. At least six months.
• D. At a work site with 50 employees within a 75-mile radius.

Correct answer: C

Rationale: Employees are eligible to take a leave of absence if they have worked for the employer for at least 12 months, have worked at least 1,250 hours during the previous 12 months, and are at a work site with 50 or more employees, or at a site where 50 workers are employed within 75 miles of the work site. The statement 'At least six months' is incorrect as the requirement is for 12 months of work to be eligible for a leave of absence.

3. Many patient classification systems have some type of shortcoming. Among these are:

• A. The client's condition changes before the next shift.
• B. The staffing needs are predicted on a short-term basis.
• C. The potential admissions cannot be accounted for.
• D. The staffing mix changes because of illness.

Correct answer: C

Rationale: Patient classification systems have limitations in accounting for changes in a client's condition, unexpected influx of new admissions, and changes in staffing due to illness. These systems often focus on short-term staffing needs rather than utilizing demand management, which considers client outcomes to predict staffing needs over a longer period. Not being able to account for potential admissions can lead to challenges in effectively managing staff allocation and resources. Choices A, B, and D are incorrect because they do not address the specific limitation of patient classification systems related to accounting for potential admissions.

4. Which of the following best describes the role of a nurse preceptor?

• A. Supervisor of all nursing staff
• B. Mentor and educator for new nurses
• C. Director of nursing services
• D. Coordinator of patient care

Correct answer: B

Rationale: The correct answer is B: 'Mentor and educator for new nurses.' A nurse preceptor plays a crucial role in mentoring and educating new nurses. They provide guidance, support, and practical knowledge to help new nurses transition smoothly into their roles. While preceptors may have supervisory responsibilities during the orientation period, their primary focus is on supporting the professional development of new nurses, rather than supervising all nursing staff, directing nursing services, or coordinating patient care. Choice A is incorrect because a nurse preceptor does not supervise all nursing staff but focuses on new nurses. Choice C is incorrect as the role of a director of nursing services involves overall management and leadership of nursing services. Choice D is incorrect as a coordinator of patient care is responsible for organizing patient care activities, not specifically focused on mentoring new nurses.

5. 1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?

• A. Blood pressure
• B. Serum creatinine
• C. Chest x-ray
• D. Urine for microalbuminuria

Correct answer: C

Rationale: The correct answer is C: Chest x-ray. While monitoring for complications in a patient with type 2 diabetes, annual tests such as blood pressure measurement, serum creatinine levels, and urine for microalbuminuria are essential. These tests help in assessing kidney function, cardiovascular health, and early signs of kidney damage, which are common complications of diabetes. A chest x-ray is not routinely scheduled annually to monitor for complications related to type 2 diabetes, making it the least applicable option.

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