Nursing Elites

1. Which of the following best describes the role of a nurse advocate?

• A. Direct patient care provider
• B. Advocate for patient needs
• C. Manage nursing staff
• D. Ensure policy adherence

Correct answer: B

Rationale: The correct answer is B: 'Advocate for patient needs.' A nurse advocate's primary role is to stand up for the patient's rights and ensure their needs are met. Choice A, 'Direct patient care provider,' is incorrect as while nurses do provide direct patient care, the specific role of a nurse advocate goes beyond that. Choice C, 'Manage nursing staff,' is incorrect as this pertains to a nurse manager's role, not a nurse advocate. Choice D, 'Ensure policy adherence,' is also incorrect as this reflects more of a quality assurance or compliance role, rather than the advocacy role of a nurse advocate.

2. As a new nurse on a pediatric unit, you must work nights and you have minimal time to spend with your children. Your colleague observes that you speak abruptly with parents and you become easily annoyed when the patients cry or when they are demanding. You realize you are becoming increasingly more distressed and that you have no time with your children and, as a result you: (Select all that apply.)

• A. Express negative comments to colleagues about patients and parents who annoy you.
• B. Ask the nurse manager to have a schedule with an equal number of day and night shifts so that you can be with your children.
• C. Call off sick as frequently as you can without violating policies so that you have more time with your children.
• D. Minimize your communication with patients and parents so you do not offend them.

Correct answer: B

Rationale: The correct answer is B. Asking the nurse manager for a schedule with an equal number of day and night shifts is a proactive and constructive approach to address the issue of having minimal time with your children. This solution aims to balance work and personal life effectively. Choices A, C, and D are incorrect. Expressing negative comments about patients and parents (Choice A) is unprofessional and can create a negative work environment. Calling off sick frequently (Choice C) is irresponsible and violates work policies, leading to potential disciplinary actions. Minimizing communication with patients and parents (Choice D) is not a suitable approach as effective communication is essential in healthcare to provide optimal care and support to patients and their families.

3. After change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

4. Which theory emphasizes the long-range plan rather than rewards?

• A. Equity theory.
• B. Development.
• C. Goal setting.
• D. Extinction.

Correct answer: C

Rationale: The correct answer is C, Goal setting. Goal-setting theory emphasizes that it is the goal itself that motivates a person to exert effort, not just the rewards or outcomes. This theory focuses on setting specific and challenging goals to enhance performance. Choices A, B, and D are incorrect because Equity theory relates to fairness in social exchanges, Development theory concerns personal growth and advancement, and Extinction refers to the disappearance of a behavior when it is no longer reinforced.

5. An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN’s friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying?

• A. Fidelity
• B. Confidentiality
• C. Veracity
• D. Accountability

Correct answer: B

Rationale: The principle of confidentiality requires nurses to hold healthcare information and anything patients tell them in the strictest confidence.

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