Nursing Elites

1. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?

• A. Urine dipstick for glucose
• B. Oral glucose tolerance test
• C. Fasting blood glucose level
• D. Glycosylated hemoglobin level

Correct answer: D

Rationale: The correct answer is D: Glycosylated hemoglobin level. Glycosylated hemoglobin, also known as hemoglobin A1c, provides a long-term indicator of blood glucose control over the past 2-3 months. It is a valuable tool in assessing the effectiveness of diabetes treatment because it reflects average blood sugar levels during this period. Choices A, B, and C are not as effective for evaluating long-term glucose control. Urine dipstick for glucose only provides a snapshot of glucose levels at the time of testing, oral glucose tolerance test evaluates how the body processes glucose after drinking a sugary solution, and fasting blood glucose level gives a point-in-time measurement of glucose levels after fasting, but they do not reflect the overall glucose control over several months.

2. Politics is defined as the art of influencing the allocation of scarce resources. An example of a scarce resource allocated by the manager of a patient care unit is:

• A. Raises for the staff.
• B. Patient supplies in the utility room.
• C. Staffing that minimizes overtime.
• D. Paper for the printer.

Correct answer: C

Rationale: In a healthcare setting, scarce resources can include money, time, personnel, and materials. Staffing decisions directly impact the allocation of personnel resources and can affect overtime costs, making it a critical resource managed by the unit manager. Patient supplies in the utility room and paper for the printer are important, but staffing decisions have a more direct impact on resource allocation within the unit. Raises for staff are typically granted by the institution and are not directly controlled by the unit manager.

3. Which of the following scenarios would be an example of shared governance on a nursing unit?

• A. Staff nurses delegate activities to CNAs.
• B. Procedure manuals are written by a committee of nurse managers.
• C. Staff nurses and CNAs make their own schedules.
• D. A unit manager seeks advice from her supervisor.

Correct answer: C

Rationale: The correct answer is C. Shared governance in a nursing unit involves staff nurses and CNAs having autonomy and decision-making power in aspects like scheduling, which is reflected in them making their own schedules. This scenario aligns with the philosophy of shared governance where nursing practice is best determined by nurses. Choices A, B, and D do not exemplify shared governance as they involve hierarchical delegation, managerial decision-making, and seeking advice from superiors rather than autonomous decision-making by frontline staff.

4. A unit manager has been working to decrease the incidence of catheter-associated urinary tract infections on his unit, spending extra time on the unit researching best practices and conducting training. Having completed training, the manager decides to take a couple of days off. Which of the following leadership traits is this unit manager displaying?

• A. Perseverance
• B. Balance
• C. Generosity
• D. Ability to handle stress

Correct answer: B

Rationale: The correct answer is 'Balance.' The unit manager is displaying balance by recognizing the importance of taking time off to rest and recharge after working diligently to decrease infections. 'Perseverance' is not the correct choice because the manager is taking time off, not persisting in the face of challenges. 'Generosity' and 'Ability to handle stress' are also incorrect as they do not align with the situation described.

5. What is the primary focus of the Institute for Healthcare Improvement (IHI)?

• A. Patient safety
• B. Cost reduction
• C. Healthcare innovation
• D. Research funding

Correct answer: A

Rationale: The primary focus of the Institute for Healthcare Improvement (IHI) is patient safety. IHI is renowned for its efforts in developing and implementing evidence-based practices to enhance patient safety and improve the quality of care in healthcare settings. While cost reduction, healthcare innovation, and research funding are important aspects of healthcare, the core mission of the IHI revolves around prioritizing patient safety. Patient safety involves reducing medical errors, improving care processes, and creating a safer environment for patients, which are all fundamental to the work of the IHI.

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