Nursing Elites

1. A nurse manager who tells the staff to 'come to me with any problem' but then keeps the office door closed is using what type of communication?

• A. Intrasender conflict
• B. Diagonal communication
• C. Metacommunication
• D. Upward communication

Correct answer: A

Rationale: The correct answer is A: Intrasender conflict. Intrasender conflict happens when there is a discrepancy between verbal and nonverbal communication. In this scenario, the nurse manager's verbal message encourages staff to communicate openly, but the closed office door sends a conflicting nonverbal message, creating intrasender conflict. Metacommunication involves nonverbal behaviors like gestures or facial expressions that support or contradict verbal communication. Upward communication refers to the flow of information from staff to management or lower to upper management. Diagonal communication involves communication between individuals or departments at different hierarchical levels.

2. In our culturally diverse society, barriers to health care result from:

• A. Prejudice
• B. Different socioeconomic status
• C. Differences in language
• D. All of the above

Correct answer: D

Rationale: In a culturally diverse society, barriers to health care can stem from various factors. These include differences in language, various socioeconomic statuses, and prejudices. These factors can create obstacles for individuals in accessing healthcare services. Therefore, the correct answer is 'All of the above' as all the provided choices contribute to barriers in healthcare access. Choice A, 'Prejudice,' is correct as biases and discrimination can prevent individuals from receiving proper care. Choice B, 'Different socioeconomic status,' is accurate as financial disparities can limit access to healthcare services. Choice C, 'Differences in language,' is also valid as language barriers can hinder effective communication and understanding between patients and healthcare providers.

3. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

• A. Avoid snacking at bedtime.
• B. Increase the rapid-acting insulin dose.
• C. Check the blood glucose during the night.
• D. Administer a larger dose of long-acting insulin.

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

4. An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?

• A. One or more of the parties may be able to reconcile their values.
• B. The patient�s point of view is recognized as valuable.
• C. The dilemma involves two or more equally unpleasant choices.
• D. The institution is unable to honor the patient�s request.

Correct answer: D

Rationale: A patient may make a request that is not possible within the institution. When this occurs, a solution may not be possible within the institution and the patient may need to be transferred to a different institution that may be able to honor the request.

5. One of the critical elements in interviewing is:

• A. Time management during the interview.
• B. Involving others in the interview process.
• C. Choosing the interview location.
• D. Developing an interview guide.

Correct answer: D

Rationale: Developing an interview guide is a critical element in interviewing as it allows for a systematic approach. An interview guide helps the interviewer stay on track, ensures important topics are covered, and provides consistency in questioning. Options A, B, and C are not as crucial as developing an interview guide. Time management during the interview is important but not the critical element being addressed in this question. Involving others may be beneficial in some cases, but it is not a fundamental element of interviewing. While choosing a suitable interview location is essential for a conducive environment, it is not as central as having a structured interview guide.

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