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. What is the primary focus of Lean methodology in healthcare?

• A. Reduce healthcare costs
• B. Enhance patient satisfaction
• C. Increase patient throughput
• D. Standardize care processes

Correct answer: D

Rationale: The correct answer is D: Standardize care processes. Lean methodology in healthcare focuses on standardizing care processes to improve efficiency and reduce waste. While reducing healthcare costs and enhancing patient satisfaction are important goals in healthcare, the primary focus of Lean methodology is to standardize care processes to ensure consistent, high-quality care delivery. Increasing patient throughput may be a byproduct of implementing Lean principles but is not the primary focus.

3. What is the main purpose of a nursing code of ethics?

• A. To protect the rights and dignity of patients
• B. To ensure compliance with healthcare laws
• C. To set standards for clinical practice
• D. To provide a framework for ethical decision-making in nursing practice

Correct answer: D

Rationale: The main purpose of a nursing code of ethics is to provide a framework for ethical decision-making in nursing practice. While choice A is important, the primary focus of a nursing code of ethics is not solely to protect the rights and dignity of patients but to guide nurses in making ethical decisions. Choice B is more related to legal requirements, not the ethical aspects covered by a code of ethics. Choice C, setting standards for clinical practice, is important but distinct from the primary purpose of a code of ethics, which is centered on ethical decision-making.

4. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

• A. Lispro (Humalog)
• B. Glargine (Lantus)
• C. Detemir (Levemir)
• D. NPH (Humulin N)

Correct answer: A

Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

5. Which regulatory body mandates the provision of immunizations, especially for hepatitis B?

• A. American Nurses Association (ANA)
• B. Occupational Safety and Health Administration (OSHA)
• C. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
• D. State board of nursing

Correct answer: B

Rationale: The correct answer is B - Occupational Safety and Health Administration (OSHA). OSHA mandates that the hepatitis B vaccine series must be offered to healthcare workers who are not immune to hepatitis. This requirement aims to protect healthcare workers from occupational exposure to bloodborne pathogens, including the hepatitis B virus. The American Nurses Association (ANA) (Choice A) is a professional organization for nurses, not a regulatory body. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (Choice C) focuses on accrediting healthcare organizations for quality and safety, not mandating immunizations. The State board of nursing (Choice D) is responsible for regulating nursing practice within a specific state, not mandating immunizations.

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