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. An RN enters a patient�s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?

• A. The RN tells the client he is not allowed to leave until the physician has released him.
• B. The RN asks the client why he wishes to leave.
• C. The RN asks the client to explain what he understands about his medical diagnosis.
• D. The RN asks the client to sign an against medical advice discharge form.

Correct answer: A

Rationale: Verbal or physical detainment of a client who desires to leave the institution is false imprisonment.

3. 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.

4. What is the main goal of discharge planning?

• A. To ensure that patients are discharged as quickly as possible
• B. To prevent hospital readmissions
• C. To educate patients about their medications
• D. To transition patients from one level of care to another

Correct answer: B

Rationale: The main goal of discharge planning is to prevent hospital readmissions by ensuring patients have a clear and effective plan for post-discharge care. This includes coordinating follow-up appointments, medication management, and providing necessary support services to promote a successful transition from the hospital to home or another care setting. Choices A, C, and D are incorrect because discharge planning is not primarily about speedy discharge, medication education, or transitioning between care levels; its main focus is on preventing readmissions through comprehensive post-discharge care.

5. Which of the following is a trait that was found to be common among leaders in trait theory?

• A. Communication of duties assigned
• B. Adaptability and changing priorities
• C. Order giving and decision making for a group
• D. Communication of goal direction

Correct answer: D

Rationale: The correct answer is D, 'Communication of goal direction.' Trait theory suggests that effective leaders possess certain traits, one of which is the ability to clearly communicate the direction and goals of the group. This trait helps in aligning the efforts of the team towards a common objective. Choices A, B, and C are incorrect because while communication, adaptability, decision-making, and order giving are important skills for leaders, the specific trait commonly associated with leaders in trait theory is the ability to communicate the direction and goals.

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