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. Lippitt's phases of change are important factors in the change process. The phase that involves key people in data collection is known as:

• A. Assess the motivation.
• B. Choose a change agent.
• C. Diagnose the problem.
• D. Maintain the change.

Correct answer: C

Rationale: The correct answer is C: 'Diagnose the problem.' In Lippitt's phases of change, the first step is to diagnose the problem, which involves key people in data collection and problem-solving. This step is crucial as it helps identify the root causes of the issues that need to be addressed. Assessing the motivation (A) comes later in the change process once the problem has been diagnosed. Choosing a change agent (B) and maintaining the change (D) are also important steps in the change process but do not specifically involve key people in data collection as in the diagnosis phase.

3. When is the first opportunity for a manager to reduce turnover?

• A. When the decision to hire a new employee is made
• B. After one month of employment
• C. After three months of employment
• D. After a certain tenure period

Correct answer: C

Rationale: The manager's first opportunity to reduce turnover occurs after three months of employment. During this period, the manager can assess the employee's performance, engagement, and fit within the organization. It allows the manager to address any concerns, provide support, and intervene early to prevent turnover. Waiting until after a certain tenure period might be too late to effectively mitigate turnover risk, as issues could have already escalated. Therefore, the three-month mark is a critical point for managers to proactively manage turnover. Choices A and B are incorrect because they do not allow sufficient time for the manager to evaluate the employee and take proactive measures to reduce turnover. Choice D is incorrect as it is too vague and does not provide a specific actionable timeframe for addressing turnover concerns.

4. An RN enters a patient�s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?

• A. The RN tells the client he is not allowed to leave until the physician has released him.
• B. The RN asks the client why he wishes to leave.
• C. The RN asks the client to explain what he understands about his medical diagnosis.
• D. The RN asks the client to sign an against medical advice discharge form.

Correct answer: A

Rationale: Verbal or physical detainment of a client who desires to leave the institution is false imprisonment.

5. When communicating with a client who has a complaint, what principle is important to keep in mind?

• A. Supervisors should always be involved.
• B. The client's physician is often the cause of the problem.
• C. Avoid discussion of complaints.
• D. Clients and families should be treated with respect; communication should be open and honest.

Correct answer: D

Rationale: When addressing complaints from clients, it is crucial to prioritize treating clients and families with respect. Open and honest communication fosters trust and transparency in resolving issues effectively. This client-centered approach emphasizes the importance of maintaining positive relationships within the healthcare setting. Choices A, B, and C are incorrect. Involving supervisors in every communication with a client who has a complaint may not always be necessary or practical. Blaming the client's physician for the issue is unprofessional and does not address the client's concerns. Avoiding discussion of complaints can lead to unresolved issues and dissatisfaction among clients.

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