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. Which of the following are effective strategies to become more resilient? (EXCEPT)

• A. Exercising and avoiding high-fat foods.
• B. Managing time effectively.
• C. Becoming more self-aware.
• D. Deciding that your career is not your highest priority.

Correct answer: D

Rationale: Resilience can be enhanced through various strategies such as exercising, managing time effectively, and becoming more self-aware. Deciding that your career is not your highest priority may not necessarily contribute to building resilience as it does not directly address the personal traits and coping mechanisms associated with resilience. This choice focuses more on prioritization rather than the specific skills and mindset needed to bounce back from challenges. Sherman's study (2004) highlighted the importance of self-awareness in preventing burnout among nurses, emphasizing the value of self-care and personal well-being in maintaining resilience.

3. What information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs?

• A. Select flat-soled leather shoes
• B. Apply heating pads on a low temperature.
• C. Avoid using callus remover for corns or calluses.
• D. Refrain from soaking feet in warm water for an hour each day.

Correct answer: A

Rationale: The correct answer is to select flat-soled leather shoes. Patients with peripheral arterial disease, type 2 diabetes, and sensory neuropathy are at risk for foot injuries due to decreased sensation and poor circulation. Flat-soled leather shoes can help prevent injuries and provide adequate support without causing pressure points. Choice B is incorrect as using heating pads can lead to burns for patients with sensory neuropathy. Choice C is wrong because using callus remover may lead to skin damage for patients with compromised circulation. Choice D is not recommended as soaking feet in warm water can further damage the skin due to decreased sensation.

4. 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.

5. Which of the following laws govern nursing practice?

• A. Statutory laws
• B. Common laws
• C. Administrative laws
• D. Constitutional laws

Correct answer: A

Rationale: Statutory laws govern nursing practice. These laws are enacted by legislative bodies and regulate various aspects of nursing practice, including licensure requirements, scope of practice, and patient care standards. Common laws, administrative laws, and constitutional laws may also impact nursing practice, but statutory laws specifically outline the legal framework for nursing professionals to follow. Common laws are based on court decisions and precedents, not specific to nursing practice. Administrative laws deal with regulations set by administrative agencies. Constitutional laws relate to the fundamental rights and principles outlined in the constitution, not specifically governing nursing practice.

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