Nursing Elites

1. Which of the following factors contributes to conflicts in professional nursing today?

• A. Some nurses who had planned to retire but find themselves forced to continue working because of the current economic situation
• B. Balancing state practice acts, codes of ethics, and standards of practice
• C. Advances in technology
• D. Multiple generations in the workforce

Correct answer: D

Rationale: The presence of multiple generations in the nursing workforce today with diverse viewpoints and work styles can lead to conflicts. This diversity in perspectives and approaches may result in disagreements on how tasks should be done or how patient care should be managed. Option A refers to economic factors impacting individual nurses rather than conflicts within the profession. Option B is related to compliance and ethical considerations, not conflicts. Option C, advances in technology, may influence nursing practices but is not directly linked to conflicts among professionals.

2. A client experiences difficulty breathing after the change of shift. The nurse on duty discovers that the IVFs were infusing at a rate 10 times the calculated normal. After notifying the physician and correcting the rate, what should be the next step in the client's care?

• A. Notify family
• B. Discipline the previous nurse
• C. Complete an incident report
• D. Obtain legal consultation

Correct answer: C

Rationale: The correct next step in the client's care after notifying the physician and correcting the rate of IVFs is to complete an incident report. This report is essential for documenting the adverse event, analyzing the cause, and implementing preventive measures to avoid similar incidents in the future. Notifying the family, disciplining the previous nurse, and obtaining legal consultation are not immediate priorities in this situation. Family notification may follow the incident report, disciplining the previous nurse is a separate administrative process, and legal consultation is usually not required for a medical error corrected promptly.

3. A nurse is caring for a client who is scheduled to be transferred to a long-term care facility. The client's family questions the nurse about the reasons for the transfer. Which of the following responses made by the nurse is appropriate?

• A. The transfer of your family member is being done because the provider knows what's best.
• B. Would you like us to discuss the transfer with your family member?
• C. Why are you so concerned about this transfer?
• D. I know how you feel. My parent had to be transferred to a long-term care facility.

Correct answer: A

Rationale: The correct response is A because it provides a professional and reassuring explanation for the transfer, focusing on the expertise of the healthcare provider. Choice B offers to include the family member in the discussion, which may not address their concerns directly. Choice C appears defensive and does not address the family's inquiry. Choice D shifts the focus to the nurse's personal experience, which may not be relevant or helpful to the family seeking information about their own situation.

4. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution’s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: The director should follow her institution’s formal process for reporting and handling practices that jeopardize patient safety.

5. What should the nurse do after a 36-year-old patient treated with intramuscular glucagon for hypoglycemia regains consciousness?

• A. Assess the patient for symptoms of hyperglycemia.
• B. Give the patient a snack of peanut butter and crackers.
• C. Have the patient drink a glass of orange juice or nonfat milk.
• D. Administer a continuous infusion of 5% dextrose for 24 hours.

Correct answer: B

Rationale: After a patient treated with intramuscular glucagon for hypoglycemia regains consciousness, providing a snack of peanut butter and crackers is essential to prevent another episode of hypoglycemia. Peanut butter and crackers contain a combination of protein and carbohydrates, which can help stabilize the patient's blood glucose levels. This choice is the most appropriate immediate action to prevent recurrence of hypoglycemia in this scenario. Assessing for symptoms of hyperglycemia (choice A) is not the immediate priority after treating hypoglycemia. While orange juice or nonfat milk (choice C) can help raise blood sugar, they lack the sustained effect of protein found in peanut butter. Administering a continuous infusion of dextrose (choice D) is excessive and not indicated after the patient has already regained consciousness.

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