Nursing Elites

1. Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)?

• A. Glyburide decreases glucagon secretion from the pancreas.
• B. Glyburide stimulates insulin production and release from the pancreas.
• C. Glyburide should be taken even if the morning blood glucose level is low.
• D. Glyburide should not be used for 48 hours after receiving IV contrast media.

Correct answer: B

Rationale: The correct answer is B: Glyburide stimulates insulin production and release from the pancreas. Glyburide belongs to the sulfonylurea class of antidiabetic medications, which work by stimulating the pancreas to produce and release more insulin. This helps to lower blood glucose levels. Choice A is incorrect because glyburide does not decrease glucagon secretion; instead, it acts on insulin. Choice C is incorrect because taking glyburide when blood glucose is low can lead to hypoglycemia. Choice D is incorrect as there is no specific interaction between glyburide and IV contrast media that requires avoiding its use for 48 hours.

2. One reason for conducting a comprehensive medical exam on an applicant is:

• A. It is needed to protect the organization from legal actions.
• B. It is required after a strenuous interview.
• C. It is mandated by law.
• D. It is necessary to screen for disabilities that may impact employment.

Correct answer: A

Rationale: Conducting a comprehensive medical exam on an applicant is crucial to protect the organization from legal actions. This examination helps ensure that the applicant meets the health standards required for the job, reducing the risk of potential liabilities for the organization related to health issues that may arise during employment. Choice B is incorrect because the exam is not a follow-up to a strenuous interview. Choice C is incorrect as not all comprehensive medical exams are mandated by law; they are often part of an organization's policy. Choice D is incorrect as the primary goal of the exam is to assess the applicant's health status in relation to the job requirements, not to screen for disabilities.

3. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

4. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

• A. Lispro (Humalog)
• B. Glargine (Lantus)
• C. Detemir (Levemir)
• D. NPH (Humulin N)

Correct answer: A

Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

5. A staff nurse describes the unit manager as 'a born leader.' The nurse ascribes to which theory of leadership?

• A. Trait theories
• B. Behavioral theories
• C. Formal leadership theories
• D. Democratic leadership theories

Correct answer: A

Rationale: The correct answer is A: Trait theories. The nurse describing the unit manager as 'a born leader' aligns with trait theories of leadership, which suggest that certain inborn characteristics or traits contribute to effective leadership. This theory emphasizes that leaders possess natural qualities that make them suitable for leadership roles. Choices B, C, and D are incorrect. Behavioral theories focus on the actions and behaviors of leaders, formal leadership theories emphasize organizational structure and roles, and democratic leadership theories pertain to a style of leadership that involves participative decision-making.

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