Nursing Elites

1. A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating:

• A. The test needs to be repeated following a 12-hour fast.
• B. It appears you aren't following the prescribed diabetic diet.
• C. It tells us about your sugar control for the last 3 months.
• D. Your insulin regimen needs to be significantly altered.

Correct answer: C

Rationale: The correct answer is C. Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the past 3 months. This test is used to assess long-term blood sugar control in individuals with diabetes. Choice A is incorrect because fasting is not required for an HbA1c test. Choice B is judgmental and not supported by the information provided. Choice D is not the most accurate statement to make based on the HbA1c result; adjusting insulin would depend on a more comprehensive assessment of the client's overall diabetes management.

2. To be effective, a nurse manager needs both managerial and leadership skills. Interpersonal activities have many concerns that overlap both leaders and managers. However, some interpersonal activities are needed by nurse managers, but are not specific duties of leaders. Which of the following is an interpersonal activity of nurse managers, but not necessarily all nurse leaders?

• A. Coaching
• B. Resource allocation
• C. Planning for the future
• D. Monitoring

Correct answer: B

Rationale: Resource allocation is an interpersonal activity specific to nurse managers because it involves managing the distribution of resources within the healthcare environment, which is not necessarily a duty for all leaders. While coaching, planning for the future, and monitoring are important skills for both leaders and managers, resource allocation is a task that is more specific to the managerial role of nurse managers.

3. Which of the following best defines management?

• A. A manager is someone who ensures that employees complete their work.
• B. A manager controls the work of employees.
• C. A manager organizes and controls a group of employees to get work done.
• D. A manager accomplishes tasks through planning, organizing, commanding, coordinating, and controlling work groups.

Correct answer: D

Rationale: The best definition of management encompasses the comprehensive process of planning, organizing, commanding, coordinating, and controlling work groups to achieve organizational goals. Choice A is too limited, focusing only on ensuring work completion. Choice B is overly restrictive as management involves more than mere control. Choice C is more specific than the correct answer, which encompasses a broader range of managerial functions.

4. Working in a stressful work environment, nursing requires effective nurse managers. Which of the following skills is necessary for a nurse manager to be effective?

• A. Clinical knowledge
• B. Managerial skills
• C. Patient care coordination
• D. Human resource training

Correct answer: B

Rationale: Managerial skills are crucial for nurse managers to be effective. They need to possess skills such as problem-solving and decision-making to handle various challenges in the healthcare setting. Clinical knowledge (choice A) is important for direct patient care but may not be the primary focus of a manager's role. Patient care coordination (choice C) is vital, but managerial skills are more directly related to a nurse manager's effectiveness. Human resource training (choice D) is helpful but not as essential as managerial skills in ensuring effective leadership in a nursing environment.

5. What clinical feature distinguishes a hypoglycemic reaction from a ketoacidosis reaction?

• A. Blurred vision.
• B. Diaphoresis.
• C. Nausea.
• D. Weakness.

Correct answer: B

Rationale: Diaphoresis is the correct answer because it is more characteristic of hypoglycemia. Hypoglycemia typically presents with symptoms such as diaphoresis (excessive sweating), palpitations, tremors, and anxiety. On the other hand, ketoacidosis is associated with symptoms such as fruity breath, deep and labored breathing (Kussmaul respirations), nausea, vomiting, and abdominal pain. Blurred vision can occur in both hypoglycemia and ketoacidosis due to metabolic disturbances affecting the eyes. Weakness is a nonspecific symptom that can be present in both conditions, making it less helpful in distinguishing between the two.

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