Nursing Elites

1. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
• B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
• C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
• D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

2. For a 55-year-old female patient with type 2 diabetes and a nursing diagnosis of imbalanced nutrition: more than body requirements, which goal is most important?

• A. The patient will reach a glycosylated hemoglobin level of less than 7%.
• B. The patient will follow a diet and exercise plan that results in weight loss.
• C. The patient will choose a diet that distributes calories throughout the day.
• D. The patient will state the reasons for eliminating simple sugars in the diet.

Correct answer: A

Rationale: The most important goal for a 55-year-old female patient with type 2 diabetes and imbalanced nutrition due to more than body requirements is to reach a glycosylated hemoglobin level of less than 7%. This goal directly addresses the management of diabetes and is crucial in preventing complications associated with high blood sugar levels. Choice B focuses on weight loss, which may be beneficial but is not as critical as controlling blood sugar levels. Choice C, distributing calories throughout the day, is important for glycemic control but not as immediate as reaching a target HbA1c level. Choice D, stating the reasons for eliminating simple sugars, is a good educational goal but not as urgent as achieving glycemic control.

3. Cultural diversity presents an important challenge to nurse managers due to which of the following?

• A. A nursing shortage exists
• B. Staff nurses are not trained to be culturally sensitive
• C. 80% of nursing staff comes from one or more minority groups
• D. The increase in cultural diversity is seen both in the patient population and the nursing staff

Correct answer: D

Rationale: Cultural diversity presents an important challenge to nurse managers due to the increase in cultural diversity seen both in the patient population and the nursing staff. This challenge requires nurse managers to ensure that their nursing staff can effectively communicate and provide culturally competent care to patients from diverse backgrounds. Choice A is incorrect because it does not directly relate to the impact of cultural diversity. Choice B is incorrect as it focuses on the training of staff nurses rather than the overall challenge of managing cultural diversity. Choice C is incorrect as the percentage of nursing staff from minority groups, while important, is not the primary reason cultural diversity poses a challenge to nurse managers.

4. A staff nurse is working with a patient who is on a critical pathway for education in preparation for home care. Which one of the following responsibilities would the nurse address first?

• A. Taking vital signs
• B. Answering the client's questions
• C. Evaluating client teaching
• D. Reviewing the information with the client and family

Correct answer: D

Rationale: The correct answer is D. Reviewing the information with the client and family should be addressed first. This step involves ensuring that the client and family fully understand the information provided, which is crucial before proceeding with any other responsibilities. Taking vital signs (choice A) is important but not the priority in this scenario. Answering the client's questions (choice B) and evaluating client teaching (choice C) can come after reviewing the information to ensure effective communication and understanding.

5. Which of the following is a leadership style that assumes individuals are motivated by internal forces and uses participation and majority rule to get work done?

• A. Autocratic leadership
• B. Laissez-faire leadership
• C. Democratic leadership
• D. Transactional leadership

Correct answer: C

Rationale: Democratic leadership is a leadership style that operates on the belief that individuals are motivated by internal forces. It involves encouraging participation and decision-making through majority rule to accomplish tasks. This leadership approach fosters collaboration, empowerment, and involvement of team members in decision-making processes. Autocratic leadership (choice A) is characterized by centralized control and little input from team members. Laissez-faire leadership (choice B) involves minimal interference and provides little guidance or direction. Transactional leadership (choice D) is based on exchanges between leaders and followers for desired outcomes, focusing on rewards and punishments rather than internal motivation and participation.

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