Nursing Elites

1. 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.

2. Which of the following factors contributes to conflicts in professional nursing today?

• A. Some nurses who had planned to retire but find themselves forced to continue working because of the current economic situation
• B. Balancing state practice acts, codes of ethics, and standards of practice
• C. Advances in technology
• D. Multiple generations in the workforce

Correct answer: D

Rationale: The presence of multiple generations in the nursing workforce today with diverse viewpoints and work styles can lead to conflicts. This diversity in perspectives and approaches may result in disagreements on how tasks should be done or how patient care should be managed. Option A refers to economic factors impacting individual nurses rather than conflicts within the profession. Option B is related to compliance and ethical considerations, not conflicts. Option C, advances in technology, may influence nursing practices but is not directly linked to conflicts among professionals.

3. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

4. When is the first opportunity for a manager to reduce turnover?

• A. When the decision to hire a new employee is made
• B. After one month of employment
• C. After three months of employment
• D. After a certain tenure period

Correct answer: C

Rationale: The manager's first opportunity to reduce turnover occurs after three months of employment. During this period, the manager can assess the employee's performance, engagement, and fit within the organization. It allows the manager to address any concerns, provide support, and intervene early to prevent turnover. Waiting until after a certain tenure period might be too late to effectively mitigate turnover risk, as issues could have already escalated. Therefore, the three-month mark is a critical point for managers to proactively manage turnover. Choices A and B are incorrect because they do not allow sufficient time for the manager to evaluate the employee and take proactive measures to reduce turnover. Choice D is incorrect as it is too vague and does not provide a specific actionable timeframe for addressing turnover concerns.

5. The changes brought forth by the state boards of nursing are an example of which type of change agent?

• A. Resistance
• B. Empirical–rational
• C. Normative–reeducative
• D. Power–coercive

Correct answer: D

Rationale: The changes implemented by state boards of nursing typically fall under the category of Power–coercive change agents. State boards of nursing have the authority to enforce changes through regulations and policies, making use of their legitimate power. Resistance (choice A) is not the correct answer as it refers to opposition to change rather than the entity driving change. Empirical–rational (choice B) focuses on convincing individuals through empirical evidence and rational arguments, which is not reflective of the state boards' authority. Normative–reeducative (choice C) involves persuading individuals to change based on shared values and beliefs, which is not the primary approach of state boards of nursing.

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