Nursing Elites

1. Which of the following is true of malpractice?

• A. Malpractice occurs when a professional shares information about a patient that could damage that patient’s reputation.
• B. Malpractice is a serious criminal offense.
• C. Malpractice is a minor criminal offense.
• D. Malpractice is a negligent act by an individual whose duties require specialized education.

Correct answer: D

Rationale: Malpractice is a negligent act by an individual whose duties require specialized education.

2. Horizontal violence may be observed among staff interactions and causes stress among staff. To minimize stress associated with such interactions, nurses can: (Select all that apply.)

• A. Encourage venting as a way to express feelings.
• B. Take control of the situation by being assertive.
• C. Ignore staff who are volatile.
• D. Avoid interactions with angry staff.

Correct answer: B

Rationale: To minimize stress associated with horizontal violence among staff interactions, nurses should take control of the situation by being assertive. Being assertive allows nurses to address the issues causing stress in a constructive and professional manner. Encouraging venting without addressing the underlying problems may not resolve the situation effectively. Ignoring staff who are volatile can escalate the issue further, and avoiding interactions with angry staff does not address the root cause of the problem. Therefore, being assertive and addressing the situation directly is the most effective approach to minimize stress and promote a healthy work environment.

3. Verbal interventions with an agitated patient may be calming. These interventions include:

• A. Holding and reassuring the patient
• B. Encouraging other staff to distract the patient
• C. Remaining calm and keeping an arm's distance
• D. Standing close to the patient while talking

Correct answer: C

Rationale: The correct answer is C: Remaining calm and keeping an arm's distance. Agitated individuals benefit from minimal verbal and physical stimulation. They respond to their environment based on how nurses interact with them. If an individual feels threatened or cornered, the response will generally be self-protective and reactive. Standing close to the patient (choice D) can be perceived as invasive and may escalate the situation. Holding and reassuring the patient (choice A) may not be effective if the patient perceives it as intrusive. Encouraging other staff to distract the patient (choice B) may introduce unnecessary stimulation. Therefore, the recommended approach is to remain calm and keep a safe distance to provide a non-threatening environment for the agitated patient.

4. In dealing with conflict, the manager knows that feelings or perceptions about the situation will have an effect. According to Filey, what is this effect known as?

• A. Conflict suppression
• B. Resolution aftermath
• C. Antecedent conditions
• D. Manifest behavior

Correct answer: D

Rationale: Feelings or perceptions about the situation initiate behavior, known as manifest behavior. Antecedent conditions refer to preexisting conditions that may have led to the conflict but are not the immediate effect of feelings or perceptions. Resolution aftermath pertains to the consequences or outcomes following conflict resolution. Conflict suppression refers to the action of suppressing conflict without addressing its root causes, which is a subsequent step after the manifestation of behavior.

5. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?

• A. Hemoglobin A1C level is 7.9%.
• B. Last eye exam was 18 months ago.
• C. Glomerular filtration rate is decreased.
• D. Patient has questions about the prescribed diet.

Correct answer: C

Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.

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