Nursing Elites

1. A nurse needs to know how to increase her power base. Which of the following are ways nurses can generate power as described by Umiker?

• A. Using body language, standing when talking
• B. Listening for feelings
• C. Using words, avoiding clichés
• D. All of the above

Correct answer: D

Rationale: The correct answer is D: 'All of the above.' Umiker describes four ways to generate power: using words, through delivery, by listening, and through body language. Choice A is correct as it mentions using body language. Choice B is correct as it mentions listening. Choice C is correct as it pertains to using words effectively and avoiding clichés. Therefore, all the choices are ways nurses can generate power as described by Umiker.

2. After correcting the IVF infusion rate, what should be the next step in the client's care?

• A. Notify family
• B. Discipline the previous nurse
• C. Complete an incident report
• D. Obtain legal consultation

Correct answer: C

Rationale: The correct next step in the client's care after correcting the IVF infusion rate is to complete an incident report. This report is crucial for documenting the event, identifying the root cause of the error, and implementing measures to prevent similar incidents in the future. Notifying the family, disciplining the previous nurse, and obtaining legal consultation are not immediate priorities in this situation. Family notification may be necessary later but ensuring patient safety and proper documentation come first. Disciplining the previous nurse should be handled through the appropriate professional channels, not as an immediate response to the incident. Legal consultation may be needed in some cases but is not the initial step required after correcting the error and ensuring the client's safety.

3. Which of the following would be considered an urgent and important issue?

• A. Replacing two staff who were injured while caring for a violent patient
• B. Updating the employee break room with new furniture
• C. Preparing educational packets on self-administration of insulin for patients
• D. Arranging a team-building event for staff members

Correct answer: A

Rationale: The correct answer is A because replacing staff injured while caring for a violent patient is both urgent and important. This issue directly relates to staff safety and patient care, requiring immediate attention. Choice B is not urgent or crucial to patient care. Choice C is important but may not be as urgent as the situation in choice A. Choice D is not as critical as replacing injured staff, making it a less urgent and important issue.

4. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

• A. The patient always carries hard candies when engaging in exercise.
• B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
• C. The patient has a peanut butter sandwich before going for a bicycle ride.
• D. The patient increases daily exercise when ketones are present in the urine.

Correct answer: D

Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

5. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

• A. give a bolus of 50% dextrose.
• B. insert a large-bore IV catheter.
• C. initiate oxygen via nasal cannula.
• D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

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