Nursing Elites

1. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

• A. use only the lispro insulin until the symptoms are resolved
• B. limit calorie intake until the glucose is less than 120 mg/dL
• C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
• D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%

Correct answer: C

Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.

2. What is the primary goal of discharge planning?

• A. Reducing readmission rates
• B. Improving patient outcomes
• C. Ensuring continuity of care
• D. Ensuring medication adherence

Correct answer: C

Rationale: The primary goal of discharge planning is to ensure continuity of care for patients transitioning from one level of care to another. While reducing readmission rates and improving patient outcomes are important aspects of discharge planning, the main focus is on coordinating care to prevent gaps and ensure a seamless transition for the patient. Ensuring medication adherence is also crucial but falls under the broader goal of continuity of care.

3. What is the primary goal of evidence-based practice (EBP)?

• A. Reduce healthcare costs
• B. Improve patient outcomes
• C. Enhance clinical decision making
• D. Ensure patient safety

Correct answer: C

Rationale: The primary goal of evidence-based practice (EBP) is to enhance clinical decision making by integrating the best available evidence with clinical expertise and patient values. While improving patient outcomes is a significant result of EBP, the ultimate aim is to ensure that healthcare decisions are based on the most current, relevant, and reliable evidence. While reducing healthcare costs and ensuring patient safety are important in healthcare, they are not the primary goals of evidence-based practice.

4. A nurse supervisor is planning an educational session for her staff regarding improving teamwork among different generations. Which of the following recommendations will reduce potential generational conflicts?

• A. Involve only millennials in technology decisions.
• B. Focus on the team as a whole, rather than individual generations.
• C. Involve only the baby boomers in technology decisions.
• D. Practice active and assertive communication techniques.

Correct answer: D

Rationale:

5. A group of physicians comes into conflict with the nursing staff of a unit over when AM vital signs are recorded. What type of technique might be used that respects the professionalism of both parties?

• A. Accommodating
• B. Collaboration
• C. Avoiding
• D. Competing

Correct answer: B

Rationale: In this scenario, the most appropriate technique to use is collaboration. Collaboration involves working together with mutual attention to the problem, utilizing the talents of all parties involved. This approach respects the professionalism of both physicians and nursing staff by valuing their input and expertise. Choice A, accommodating, involves giving in to the other party's concerns, which may not fully address the conflict. Choice C, avoiding, suggests ignoring or sidestepping the issue, which does not promote a resolution. Choice D, competing, involves pursuing one's own concerns at the expense of the other party's, leading to a win-lose situation, which is not conducive to resolving conflicts in a professional setting.

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