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1. Which of the following is an example of a sentinel event?
- A. A patient fall with no injury
- B. A medication error that results in no harm
- C. A patient suicide while in a healthcare facility
- D. A near miss incident
Correct answer: C
Rationale: The correct answer is C, a patient suicide while in a healthcare facility. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury. Choices A, B, and D do not meet the criteria for sentinel events as described by The Joint Commission, as they do not involve death or serious harm to the patient.
2. 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.
3. In dealing with a conflict on a unit, the nurse manager decides to ask one of the staff nurses, who is not moving towards resolution, to transfer to another unit. What tactic has the manager implemented?
- A. Avoidance
- B. Withdrawal
- C. Suppression
- D. Competition
Correct answer: C
Rationale: The correct answer is C: Suppression. In this scenario, the nurse manager has implemented a suppression tactic by asking the staff nurse to transfer to another unit, which eliminates one of the conflicting parties from the current unit. This technique aims to resolve the conflict by physically separating the individuals involved. Choices A, B, and D are incorrect: Avoidance involves ignoring the conflict, withdrawal is the act of pulling out or retreating, and competition refers to a situation where one party's gain is at the expense of the other.
4. One of the perceptions of turnover is:
- A. Poor management
- B. Rejection of the job
- C. Loss of poor performers
- D. Poor job atmosphere
Correct answer: B
Rationale: The correct answer is B: 'Rejection of the job.' According to Steers and Stone, turnover can be perceived by coworkers as a rejection of the job. Choice A, 'Poor management,' is incorrect because turnover perception is more related to individual feelings about the job rather than management. Choice C, 'Loss of poor performers,' is incorrect as it focuses on the outcome of turnover rather than the perception. Choice D, 'Poor job atmosphere,' is incorrect as it describes a cause of turnover rather than a perception.
5. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?
- A. BUN 21 mg/dL (10 to 20 mg/dL)
- B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
- C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
- D. Sodium 132 mEq/L (136 to 145 mEq/L)
Correct answer: B
Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.
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