Nursing Elites

1. Which of the following best describes the concept of shared decision-making in healthcare?

• A. The process by which patients make healthcare decisions on their own
• B. A collaborative process that allows patients and providers to make healthcare decisions together
• C. A method for providers to dictate treatment plans to patients
• D. The use of evidence-based guidelines to make healthcare decisions

Correct answer: B

Rationale: The correct answer is B. Shared decision-making in healthcare involves a collaborative process between patients and providers to make healthcare decisions together. This approach considers the patient's preferences, values, and the best available evidence to reach a decision that aligns with the patient's goals. Choice A is incorrect because shared decision-making does not involve patients making decisions on their own. Choice C is incorrect as it describes a paternalistic approach where providers dictate treatment plans to patients without involving them in the decision-making process. Choice D is incorrect as it refers to the use of evidence-based guidelines, which is important but not the sole focus of shared decision-making.

2. The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose

• A. washes the puncture site using warm water and soap
• B. chooses a puncture site in the center of the finger pad
• C. hangs the arm down for a minute before puncturing the site
• D. says the result of 120 mg indicates good blood sugar control

Correct answer: B

Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad is not recommended for blood glucose monitoring. The recommended sites are the sides of the fingertips. Option A is correct as washing the puncture site using warm water and soap is a good practice. Option C is also correct as hanging the arm down for a minute can help increase blood flow. Option D is incorrect as a blood sugar level of 120 mg/dL may not necessarily indicate good blood sugar control and needs further interpretation.

3. As a new graduate employed in a high-volume maternity unit that uses differentiated practice as its staffing model, what can the nurse expect?

• A. Evidence-based practice guides risk management principles.
• B. Client teaching is the responsibility of the team leader.
• C. The initial level of practice responsibility will be limited.
• D. Seniority is the main determinant of client assignments.

Correct answer: C

Rationale: In a differentiated practice model, the scope of nursing practice and responsibility are tailored to different levels of experience. As a new graduate with limited experience, the nurse can expect that the initial level of practice responsibility will be limited to match their skill level and knowledge. This allows for a gradual increase in responsibilities as the nurse gains more experience and expertise. Choice A is incorrect because evidence-based practice is related to clinical decision-making, not the staffing model. Choice B is incorrect as client teaching is typically a shared responsibility among the healthcare team, not solely the team leader's. Choice D is incorrect as differentiated practice models focus on skill level and competence rather than seniority when determining client assignments.

4. What information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs?

• A. Select flat-soled leather shoes
• B. Apply heating pads on a low temperature.
• C. Avoid using callus remover for corns or calluses.
• D. Refrain from soaking feet in warm water for an hour each day.

Correct answer: A

Rationale: The correct answer is to select flat-soled leather shoes. Patients with peripheral arterial disease, type 2 diabetes, and sensory neuropathy are at risk for foot injuries due to decreased sensation and poor circulation. Flat-soled leather shoes can help prevent injuries and provide adequate support without causing pressure points. Choice B is incorrect as using heating pads can lead to burns for patients with sensory neuropathy. Choice C is wrong because using callus remover may lead to skin damage for patients with compromised circulation. Choice D is not recommended as soaking feet in warm water can further damage the skin due to decreased sensation.

5. An RN is explaining to a student nurse what professionalism in nursing means. Which of the following statements, if made by the student nurse, demonstrates teaching has been successful?

• A. Commitment to others means I should be honest and accountable for my actions.
• B. I should encourage my fellow nurses to talk when they are having a bad day.
• C. I should be flexible with myself and my fellow nurses when it comes to the dress code.
• D. If I need a day off, I should promptly call in sick to give my manager plenty of time to find a replacement.

Correct answer: A

Rationale: Commitment to others involves accountability for one�s actions, lifelong learning, and commitment to colleagues.

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