Nursing Elites

1. When a nurse observes a fellow nurse preparing an incorrect dose of medication, what is the best action to take?

• A. Ignore the error
• B. Administer the medication anyway
• C. Correct the error without informing the nurse
• D. Report the error to the supervisor immediately

Correct answer: D

Rationale: The best action to take when a nurse observes a fellow nurse preparing an incorrect dose of medication is to report the error to the supervisor immediately. Reporting the error is crucial to ensure patient safety and prevent any potential harm. Ignoring the error (Choice A) is not appropriate as it puts the patient at risk. Administering the medication anyway (Choice B) could harm the patient. Correcting the error without informing the nurse (Choice C) does not address the root cause of the issue, which should be brought to the attention of the supervisor for proper investigation and resolution.

2. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

• A. use only the lispro insulin until the symptoms are resolved
• B. limit calorie intake until the glucose is less than 120 mg/dL
• C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
• D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%

Correct answer: C

Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.

3. What is the primary role of the nurse manager in risk management?

• A. Ensure compliance with regulations
• B. Report incidents to higher authorities
• C. Minimize risks to patients and staff
• D. Educate staff about safe practices

Correct answer: C

Rationale: The correct answer is C: Minimize risks to patients and staff. Nurse managers play a crucial role in risk management by identifying potential risks, implementing strategies to reduce or eliminate these risks, and ensuring a safe environment for patients and staff. Choice A is incorrect because while ensuring compliance with regulations is important, the primary role of the nurse manager in risk management is to minimize risks. Choice B is incorrect as reporting incidents is part of risk management but not the primary role of a nurse manager. Choice D is also a responsibility of nurse managers, but educating staff about safe practices is not the primary focus when it comes to risk management.

4. When addressing a policy violation, what is one of the initial steps to take?

• A. Terminate the employee.
• B. Confront the employee.
• C. Discipline the employee immediately.
• D. Determine whether the employee is aware of the policy.

Correct answer: D

Rationale: When addressing a policy violation, one of the initial steps should be to determine whether the employee is aware of the policy. This step allows for clarification, feedback, and potential training if needed. Terminating the employee (Choice A) or disciplining immediately (Choice C) without assessing awareness can lead to unfair treatment and legal issues. Confronting the employee (Choice B) may be necessary but should come after establishing awareness and providing necessary support or education.

5. While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.

• A. Parallel
• B. Functional
• C. Service-integrated
• D. Matrix

Correct answer: B

Rationale: The correct answer is 'Functional.' In a functional structure, organizations group employees into departments based on specialty, where similar tasks are performed by the same group. In this scenario, the hospital organizing its departments by specialty such as nursing, dietary, and pharmacy aligns with the characteristics of a functional structure. Choice A, 'Parallel,' does not fit the scenario described; parallel structures involve separate, independent units operating in parallel with little interaction. Choice C, 'Service-integrated,' does not align with the scenario either as it involves integrating services across departments. Choice D, 'Matrix,' is not the correct answer as it involves a complex organizational structure where employees report to multiple managers simultaneously, which is not the case in the scenario provided.

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