Nursing Elites

1. After receiving change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who has a hemoglobin A1C of 12%
• B. 23-year-old with type 1 diabetes who has a blood glucose of 40 mg/dL
• C. 40-year-old who is pregnant and has an oral glucose tolerance test result of 202 mg/dL
• D. 50-year-old who uses exenatide (Byetta) and is complaining of acute abdominal pain

Correct answer: B

Rationale: The correct answer is B because the patient with a blood glucose level of 40 mg/dL (hypoglycemia) needs immediate attention. Hypoglycemia is an emergency situation that requires prompt intervention to prevent adverse effects such as seizures or loss of consciousness. Assessing and managing this patient first is crucial to prevent further deterioration. Choices A, C, and D do not present immediate life-threatening situations requiring urgent intervention like severe hypoglycemia does. While a high hemoglobin A1C level (choice A), an abnormal oral glucose tolerance test result (choice C), and acute abdominal pain (choice D) are important issues, they do not pose an immediate threat to the patient's life compared to severe hypoglycemia.

2. Which of the following best describes the role of an informatics nurse specialist?

• A. Managing electronic health records
• B. Providing technical support
• C. Educating nursing staff
• D. Improving patient care through technology

Correct answer: D

Rationale: An informatics nurse specialist focuses on improving patient care through technology by implementing, optimizing, and leveraging healthcare information systems. While managing electronic health records and providing technical support may be part of their responsibilities, the primary goal is to enhance patient outcomes and healthcare delivery through the strategic use of technology. Educating nursing staff, although important, is typically not the core role of an informatics nurse specialist.

3. When matching a job with an experienced RN, what is the first step in the selection process?

• A. Job analysis
• B. Selection techniques
• C. Methods of recruiting
• D. Assurance of legal requirements

Correct answer: A

Rationale: The correct answer is A, job analysis. Job analysis is the first step in the selection process as it involves gathering information about the duties, responsibilities, necessary skills, outcomes, and work environment of a particular job. This information is crucial in creating an accurate job description and specification that will guide the recruitment and selection process. Choices B, C, and D are incorrect because while selection techniques, methods of recruiting, and legal requirements are important aspects of the selection process, they come after the job analysis has been completed.

4. A nurse is caring for a client who is postoperative. When the nurse prepares to change the client's dressing, they say, 'Every time you change my bandage, it hurts so much.' Which of the following interventions is the nurse's priority action?

• A. Encourage the client to relax and take deep breaths during the dressing change
• B. Educate the client about the importance of the dressing change to prevent infection
• C. Administer pain medication 45 minutes before changing the client's dressing
• D. Assist the client to a comfortable position for the dressing change

Correct answer: C

Rationale: The correct answer is to administer pain medication 45 minutes before changing the client's dressing. This intervention is the priority action because the client is experiencing pain during the dressing change. Providing pain relief beforehand can help minimize the discomfort and improve the overall experience for the client. Encouraging relaxation techniques (choice A) or educating about dressing change importance (choice B) are valuable but addressing pain is the priority. Assisting the client to a comfortable position (choice D) is essential for the procedure but does not directly address the client's pain.

5. Change is a mandatory skill for managers. Successful change agents display certain characteristics. Some of these characteristics are: (Select all that apply.)

• A. Energy
• B. Confidence
• C. Ambiguity
• D. Trustworthiness

Correct answer: C

Rationale: The correct answer is 'C: Ambiguity.' The rationale behind this is that the provided list of characteristics that successful change agents demonstrate includes 'realistic thinking' as one of the traits, not 'ambiguity.' Therefore, 'A: Energy,' 'B: Confidence,' and 'D: Trustworthiness' are not among the characteristics mentioned in the extract.

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