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1. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?
- A. Measure the ankle-brachial index.
- B. Check for changes in skin pigmentation.
- C. Assess for unilateral or bilateral foot drop.
- D. Ask the patient about symptoms of depression.
Correct answer: A
Rationale: The correct answer is A: Measure the ankle-brachial index. This task involves using a Doppler ultrasound device to assess blood flow, which can be safely delegated to UAP. Choices B, C, and D require a higher level of assessment and interpretation that should be performed by licensed nursing staff. Checking for changes in skin pigmentation (B) and assessing for foot drop (C) involve more complex assessments that require nursing judgment. Asking about symptoms of depression (D) involves a psychosocial assessment, which should be performed by licensed personnel qualified to address mental health concerns.
2. Which statement by the patient indicates a need for additional instruction in administering insulin?
- A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
- B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
- C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
- D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'
Correct answer: A
Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.
3. A nurse is caring for a client with a diagnosis of terminal cancer. Which of the following statements by the client should indicate to the nurse that the client is ready to hear information regarding palliative care?
- A. "I am ready to learn about chemotherapy to help cure my cancer."
- B. "I just want you to give me something to get this over with soon."
- C. "I want you to tell me about measures available to keep me comfortable."
- D. "I know that many people have recovered fully from cancer, and so will I."
Correct answer: C
Rationale: Choice C is the correct answer because the client expressing a desire to know about measures available to keep comfortable indicates readiness for palliative care. Palliative care focuses on providing comfort, symptom management, and improving the quality of life for patients with serious illnesses such as terminal cancer. Choices A, B, and D are incorrect. Choice A indicates a desire for chemotherapy to cure the cancer, which does not align with palliative care goals. Choice B expresses a wish to end the situation quickly, which may not be in line with palliative care that focuses on comfort and quality of life. Choice D shows optimism about a full recovery, which may not be realistic for a client with terminal cancer who needs palliative care.
4. The changes brought forth by the state boards of nursing are an example of which type of change agent?
- A. Resistance
- B. Empirical–rational
- C. Normative–reeducative
- D. Power–coercive
Correct answer: D
Rationale: The changes implemented by state boards of nursing typically fall under the category of Power–coercive change agents. State boards of nursing have the authority to enforce changes through regulations and policies, making use of their legitimate power. Resistance (choice A) is not the correct answer as it refers to opposition to change rather than the entity driving change. Empirical–rational (choice B) focuses on convincing individuals through empirical evidence and rational arguments, which is not reflective of the state boards' authority. Normative–reeducative (choice C) involves persuading individuals to change based on shared values and beliefs, which is not the primary approach of state boards of nursing.
5. A manager has a budget request deadline today at 3:00. He stops his work to answer the phone, check emails as they arrive, and speak with staff who stop by his office. As a result, he misses the deadline. What best describes the cause of missing his deadline?
- A. Goal setting
- B. Organization
- C. Time wasters
- D. Assertiveness
Correct answer: C
Rationale: The best choice that describes the cause of the manager missing his deadline is 'Time wasters.' In this scenario, the manager's focus was diverted by tasks like answering the phone, checking emails, and speaking with staff, which are considered time wasters when they prevent him from meeting his deadline. Choices A, B, and D are incorrect in this context. Goal setting was not the issue as the manager was aware of the deadline; organization did not play a significant role as his tasks were interrupted by external factors, and assertiveness was not the cause of missing the deadline.
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