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. A nurse manager is using the nominal group technique to gather input from the staff on a new policy. What is the primary method of exchange in this technique?

• A. Oral presentations
• B. Email exchanges
• C. Written reports
• D. Group discussions

Correct answer: C

Rationale: In the nominal group technique, the primary method of exchange is through written reports. Participants independently generate ideas in writing, which are then shared and discussed within the group. This structured process allows for equal participation and prevents dominant individuals from influencing the group's outcome. Oral presentations (choice A) involve speaking rather than written communication, making it less suitable for the nominal group technique. Email exchanges (choice B) are also not the primary method as they lack the structured approach of the nominal group technique. Group discussions (choice D) do occur in the nominal group technique but are secondary to the initial written idea generation phase.

3. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?

• A. Document the surgeon's instructions in the client's medical record.
• B. Complete an incident report.
• C. Consult the charge nurse.
• D. Notify the nursing manager.

Correct answer: D

Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.

4. 1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?

• A. Blood pressure
• B. Serum creatinine
• C. Chest x-ray
• D. Urine for microalbuminuria

Correct answer: C

Rationale: The correct answer is C: Chest x-ray. While monitoring for complications in a patient with type 2 diabetes, annual tests such as blood pressure measurement, serum creatinine levels, and urine for microalbuminuria are essential. These tests help in assessing kidney function, cardiovascular health, and early signs of kidney damage, which are common complications of diabetes. A chest x-ray is not routinely scheduled annually to monitor for complications related to type 2 diabetes, making it the least applicable option.

5. A client with limited mobility in their lower extremities is at risk for skin breakdown. Which of the following actions should the nurse take to prevent skin breakdown?

• A. Place the client in high-Fowler's position.
• B. Increase the client's intake of carbohydrates.
• C. Massage areas of skin that are darker than the surrounding skin tissue with unscented lotion.
• D. Have the client use a trapeze bar when changing position

Correct answer: B

Rationale: The correct answer is B: Increase the client's intake of carbohydrates. Adequate nutrition, including carbohydrates, is essential for tissue repair and preventing skin breakdown. Placing the client in high-Fowler's position (choice A) may help with respiratory function but does not directly prevent skin breakdown. Massaging areas of darker skin (choice C) can cause further damage to the skin. Using a trapeze bar (choice D) may assist with changing positions but does not directly address skin breakdown prevention.

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