Nursing Elites

1. A manager has been given a deadline to complete an assignment by the end of the day. It will take every minute left of the afternoon to complete. Which interventions illustrate assertiveness to minimize interruptions in order to meet the deadline? (Select all that apply.)

• A. Allowing voicemail to answer all incoming calls or turning off email notification
• B. Delegating a discharge planning issue for a patient to one of the staff nurses
• C. Placing a 'Do Not Disturb for the Afternoon' sign on the office door
• D. All of the above

Correct answer: D

Rationale: All the interventions listed are appropriate ways to minimize interruptions. By allowing voicemail to answer calls or turning off email notifications, the manager can focus solely on the assignment. Delegating tasks to staff nurses frees up the manager's time. Placing a 'Do Not Disturb for the Afternoon' sign on the office door sends a clear message to minimize interruptions and focus on the deadline. Therefore, all of the above interventions illustrate assertiveness to meet the deadline by minimizing interruptions.

2. The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia) through a restricted access medication program. What is most important for the nurse to report immediately to the health care provider?

• A. The patient's blood pressure is 154/92.
• B. The patient has a history of emphysema
• C. The patient's blood glucose is 86 mg/dL.
• D. The patient has chest pressure when walking

Correct answer: D

Rationale: Chest pressure while walking may indicate heart-related issues such as angina or a heart attack. Rosiglitazone (Avandia) has been associated with increased risks of cardiovascular events like heart failure. Given these risks, chest pressure is an urgent symptom that must be reported immediately to prevent potentially life-threatening complications.

3. What innate tendency influences staff to act in a certain way?

• A. Instinct
• B. Appreciation
• C. Control
• D. Esteem

Correct answer: A

Rationale: The correct answer is A: Instinct. Instinct theory suggests that behaviors are influenced by inherited or innate tendencies, guiding individuals to act in specific ways without conscious reasoning. In the context of staff behavior, instinct can play a significant role in shaping their actions and responses. Choices B, C, and D are incorrect. Appreciation, control, and esteem are external factors that may influence staff behavior, but in this context, the question specifically asks for an innate tendency that influences staff to act in a certain way, which aligns more closely with instinctive tendencies rather than external factors like appreciation, control, or esteem.

4. A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about

• A. self-monitoring of blood glucose
• B. using low doses of regular insulin
• C. lifestyle changes to lower blood glucose
• D. effects of oral hypoglycemic medications

Correct answer: C

Rationale: When a patient has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L), indicating prediabetes, the initial approach is focused on lifestyle modifications to lower blood glucose levels. These changes may include dietary adjustments, increased physical activity, and weight management. Self-monitoring of blood glucose, insulin therapy, and oral hypoglycemic medications are not typically the first-line interventions for patients with prediabetes. Educating the patient about lifestyle changes to lower blood glucose is the most appropriate action at this stage.

5. The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select ONE that does not apply.)

• A. Expected length of stay
• B. Assigned staff healthcare provider
• C. Patient outcomes
• D. Medical diagnosis

Correct answer: B

Rationale: Critical pathways are designed to outline the expected sequence and timing of interventions to achieve optimal patient outcomes for a specific medical condition. Components such as the expected length of stay, patient outcomes, and medical diagnosis are crucial in developing a critical pathway for congestive heart failure. However, the assigned staff healthcare provider is not typically a fixed component of a critical pathway as it may vary based on staffing schedules and rotations. Therefore, the assigned staff healthcare provider is the component that does not apply.

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