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. By using ___________ in the workplace, nurses increase their professional influence.

• A. political skills
• B. reward power
• C. expert power
• D. power and politics

Correct answer: C

Rationale: By using expert power in the workplace, nurses increase their professional influence. Expert power is derived from an individual's knowledge, skills, or expertise in a particular area. This allows nurses to influence others based on their competence and credibility, rather than through political skills (choice A), reward power (choice B), or the combination of power and politics (choice D). While political skills and understanding power dynamics can be beneficial, expert power is particularly effective in enhancing a nurse's professional influence.

3. Which of the following would a nurse suggest are significant benefits to an organization that is considering adoption of a practice partnership model? (Select one that does not apply.)

• A. Clients express greater satisfaction.
• B. It is more expensive to implement than other models.
• C. Continuity of care is facilitated.
• D. Leadership is well accepted.

Correct answer: B

Rationale: The correct answer is B. Practice partnership models are shown to be the most cost-effective of the nursing care delivery systems, contrary to being more expensive. Clients express greater satisfaction due to the collaborative and holistic approach of this model. Continuity of care is improved when the healthcare team works together cohesively. While leadership acceptance is beneficial, it is not the most significant benefit highlighted in the context of practice partnership models.

4. Quality management and benchmarking are two approaches used to improve the quality of care. The major difference between these two approaches is which of the following?

• A. Quality management is not useful in the outpatient setting
• B. Benchmarking compares outcomes in a variety of settings and disciplines
• C. Quality management is used only in the primary care setting
• D. Benchmarking looks only at outcomes specific to nursing

Correct answer: B

Rationale: The major difference between quality management and benchmarking is that benchmarking compares outcomes in a variety of settings and disciplines. Choice A is incorrect because quality management can be applied in both inpatient and outpatient settings. Choice C is incorrect as quality management is not limited to primary care and can be implemented across various healthcare settings. Choice D is incorrect as benchmarking does not solely focus on nursing outcomes but rather compares outcomes across different disciplines and settings.

5. A nurse is evaluating teaching for a client who has heart failure. Which of the following statements by the client indicates an understanding of the teaching?

• A. I am limiting my sodium intake to 2 grams daily.
• B. I have been weighing myself every other morning.
• C. I am trying to decrease my intake of foods with potassium.
• D. I am eating fewer potato chips and more fruit for snacks.

Correct answer: A

Rationale: The correct answer is A. Limiting sodium intake is crucial for clients with heart failure to manage their condition effectively. Excessive sodium can lead to fluid retention and worsen heart failure symptoms. Weighing oneself is important for monitoring fluid retention but does not directly show an understanding of dietary restrictions. Decreasing potassium intake is not typically recommended for heart failure clients unless specifically advised by a healthcare provider. While choosing healthier snacks is beneficial, the focus on sodium intake is more critical for heart failure management.

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