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. What is the main focus of a risk management program in healthcare?

• A. To reduce hospital readmissions
• B. To manage financial resources
• C. To ensure compliance with healthcare regulations
• D. To improve clinical outcomes

Correct answer: D

Rationale: The main focus of a risk management program in healthcare is to improve clinical outcomes. By identifying and mitigating risks, healthcare organizations aim to enhance patient safety, quality of care, and overall health outcomes. Option A is incorrect because reducing hospital readmissions is a specific goal within healthcare but not the primary focus of risk management. Option B is incorrect as managing financial resources, while important, is more aligned with financial management rather than risk management. Option C is incorrect as ensuring compliance with healthcare regulations is vital but falls under compliance management rather than the primary focus of risk management, which is to improve clinical outcomes.

3. One of the most important driving forces behind health care policy changes is which of the following?

• A. New technology
• B. Outsourcing of services
• C. Emerging role of nurse practitioners
• D. Ability to pay for health care

Correct answer: D

Rationale: The correct answer is D, 'Ability to pay for health care.' One of the primary factors influencing health care policy changes is the financial aspect, as the ability to afford healthcare services affects access, quality, and equity. While new technology, outsourcing of services, and the emerging role of nurse practitioners may also impact health care policies, the fundamental driver often revolves around individuals' and societies' financial capacity to pay for healthcare.

4. There are many ways to ensure that your appraisal system is nondiscriminatory. Which of the following is one way to ensure this?

• A. Giving the appraisal once per year
• B. Having no appeal process
• C. Withholding information from the employee
• D. Not allowing any input from the employee

Correct answer: A

Rationale: To ensure that an appraisal system is nondiscriminatory, one important step is to provide the appraisal once per year. This allows for ongoing evaluation and helps prevent bias. Choice B is incorrect because having no appeal process can lead to unfair treatment without a chance for review. Choice C is incorrect as withholding information from the employee can hinder transparency and objectivity. Choice D is incorrect as not allowing any input from the employee can overlook valuable insights and perspectives that could contribute to a fair evaluation process.

5. When a client with a terminal diagnosis asks about advance directives, what should the nurse do?

• A. Engage the client and ask why they want to discuss this without their partner present.
• B. Provide information on advance directives and offer brochures.
• C. Advise the client to schedule a discussion with their provider.
• D. Focus on the client's current feelings and postpone planning for a later time.

Correct answer: A

Rationale: Choice A is the correct response as it demonstrates active listening and empathy by engaging the client in a discussion about their concerns regarding advance directives. It also recognizes the importance of involving the client's partner in such discussions, promoting shared decision-making and support. Choices B and C lack the personalized approach needed in this situation and do not address the client's immediate request for information. Choice D is incorrect as it disregards the client's expressed need to discuss advance directives and focuses solely on their current feelings, delaying a crucial conversation.

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