Nursing Elites

1. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

• A. Lispro (Humalog)
• B. Glargine (Lantus)
• C. Detemir (Levemir)
• D. NPH (Humulin N)

Correct answer: A

Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

2. The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions would be which of the following strategies?

• A. Verifying through feedback
• B. Follow-up communication
• C. Getting positive attention
• D. Knowing the context of the instruction

Correct answer: A

Rationale: Asking the subordinate to repeat the instructions is a strategy known as verifying through feedback. This approach ensures that the receiver has understood the request correctly. Choice B, 'Follow-up communication,' refers to checking in after the initial communication, not necessarily asking for repetition. Choice C, 'Getting positive attention,' is unrelated to confirming understanding. Choice D, 'Knowing the context of the instruction,' deals with understanding the background or reasons behind the instructions, not confirming comprehension.

3. Which of the following are NOT outcomes of a job analysis? (EXCEPT)

• A. Job specification
• B. Job evaluation
• C. Job description
• D. Job performance

Correct answer: C

Rationale: The correct answer is C. Job description is actually one of the key outcomes of a job analysis. A job description details the duties, responsibilities, and requirements of a specific job role. Job specification, job evaluation, and job performance are not outcomes of a job analysis. Job specification refers to the specific qualifications and skills required for a job, job evaluation involves determining the relative worth of different jobs within an organization, and job performance relates to how well an employee is executing their job duties.

4. 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.

5. What is the primary role of a nurse in an interdisciplinary team?

• A. To lead the healthcare team
• B. To advocate for the patient
• C. To provide emotional support to the patient
• D. To ensure compliance with regulations

Correct answer: B

Rationale: The correct answer is B: 'To advocate for the patient.' Nurses play a crucial role in interdisciplinary teams by ensuring that the patient's needs and preferences are considered in the care plan. While leadership (Choice A) can be a part of a nurse's responsibilities in certain situations, the primary role is patient advocacy. Providing emotional support (Choice C) is important but not the primary role in an interdisciplinary team. Ensuring compliance with regulations (Choice D) is important but not the primary focus when working within an interdisciplinary team.

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