Nursing Elites

1. Employees are eligible to take a leave of absence if they have worked for the employer for at least: (EXCEPT)

• A. At least 1,250 hours during the previous 12 months.
• B. At least 12 months.
• C. At least six months.
• D. At a work site with 50 employees within a 75-mile radius.

Correct answer: C

Rationale: Employees are eligible to take a leave of absence if they have worked for the employer for at least 12 months, have worked at least 1,250 hours during the previous 12 months, and are at a work site with 50 or more employees, or at a site where 50 workers are employed within 75 miles of the work site. The statement 'At least six months' is incorrect as the requirement is for 12 months of work to be eligible for a leave of absence.

2. 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.

3. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

4. Which statement to a patient newly diagnosed with type 2 diabetes is correct?

• A. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
• B. Insulin is not used to control blood glucose in patients with type 2 diabetes.
• C. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
• D. Type 2 diabetes is usually diagnosed when the patient is admitted with a hyperglycemic coma.

Correct answer: C

Rationale: Choice C is the correct statement to convey to a patient newly diagnosed with type 2 diabetes. Lifestyle modifications, such as changes in diet and exercise, are essential components of managing type 2 diabetes. These changes can help control blood glucose levels and improve overall health. Options A, B, and D are incorrect statements. While complications of type 2 diabetes can be serious, they are different from those of type 1 diabetes. Some patients with type 2 diabetes may require insulin therapy, but it is not true that insulin is not used at all. Type 2 diabetes is not typically diagnosed during a hyperglycemic coma, as it is usually identified through routine screenings or symptoms unrelated to a coma.

5. The staff of a medical-surgical unit is in disagreement about holiday scheduling. The nurse manager knows that this is what type of conflict?

• A. Intragroup conflict
• B. Intergroup conflict
• C. Interpersonal conflict
• D. Intrapersonal conflict

Correct answer: A

Rationale: The correct answer is A: Intragroup conflict. Intragroup conflict occurs within one group, in this case, the staff of the medical-surgical unit. Intergroup conflict, on the other hand, happens between two or more groups. Interpersonal conflict involves conflicts between two or more individuals, and intrapersonal conflict is conflict within one individual. Since the disagreement about holiday scheduling involves members within the same group (staff of the medical-surgical unit), it is an example of intragroup conflict. Therefore, the nurse manager would recognize this as an intragroup conflict rather than any of the other types mentioned.

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