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 is one of the positive benefits of conflict within an organization?

• A. Conflict leads to compromise on values and beliefs.
• B. Conflict leads to intergroup competition.
• C. Conflict helps people recognize differences and motivates people towards improved performance.
• D. Conflict always leads to a win-win resolution.

Correct answer: C

Rationale: The correct answer is C. Conflict within an organization can help people recognize legitimate differences and motivate them towards improved performance. This recognition of differences can lead to constructive discussions and solutions. Choice A is incorrect because conflict does not necessarily always lead to compromising values and beliefs. Choice B is incorrect as conflict should not be about fostering intergroup competition but rather about addressing and resolving issues. Choice D is incorrect as conflicts do not always result in a win-win resolution; sometimes, compromises or trade-offs are necessary for resolution.

3. Which of the following is an example of a macro-level health policy?

• A. Local health ordinances
• B. State licensing regulations
• C. National healthcare legislation
• D. Institutional policies

Correct answer: C

Rationale: The correct answer is national healthcare legislation. This type of policy operates at a broad level, influencing healthcare delivery and financing across an entire nation. It sets overarching frameworks and regulations that impact various aspects of the healthcare system on a large scale, affecting a wide population rather than specific localities or institutions. Choices A, B, and D are not examples of macro-level health policy. Local health ordinances pertain to specific areas or communities, state licensing regulations focus on a state level, and institutional policies are internal regulations of a particular healthcare facility.

4. A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?

• A. Perceived conflict
• B. Disruptive conflict
• C. Competitive conflict
• D. Felt conflict

Correct answer: B

Rationale: The correct answer is 'Disruptive conflict.' In disruptive conflict, the parties involved are engaged in activities to reduce, defeat, or eliminate the opponent. In this scenario, the resident and the nurse are engaging in behaviors that disrupt their professional relationship by intentionally ignoring pages and making excessive retaliatory calls. Perceived conflict refers to a situation where one or more parties believe that a conflict exists, competitive conflict involves striving to achieve personal goals at the expense of others, and felt conflict refers to the emotional involvement in a conflict situation.

5. What is the role of a nurse in a multidisciplinary team (MDT)?

• A. To lead the MDT
• B. To provide emotional support
• C. To advocate for patient needs
• D. To conduct clinical research

Correct answer: C

Rationale: In a multidisciplinary team (MDT), a nurse's role is to advocate for patient needs and ensure their perspectives are considered in the care plan. While leadership may be a part of a nurse's role in some settings, the primary focus in an MDT is collaboration and coordination. Providing emotional support is essential but may not be the primary role of a nurse in an MDT. Conducting clinical research is typically not a direct responsibility of a nurse in an MDT focused on patient care.

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