Nursing Elites

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

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

2. For a 55-year-old female patient with type 2 diabetes and a nursing diagnosis of imbalanced nutrition: more than body requirements, which goal is most important?

• A. The patient will reach a glycosylated hemoglobin level of less than 7%.
• B. The patient will follow a diet and exercise plan that results in weight loss.
• C. The patient will choose a diet that distributes calories throughout the day.
• D. The patient will state the reasons for eliminating simple sugars in the diet.

Correct answer: A

Rationale: The most important goal for a 55-year-old female patient with type 2 diabetes and imbalanced nutrition due to more than body requirements is to reach a glycosylated hemoglobin level of less than 7%. This goal directly addresses the management of diabetes and is crucial in preventing complications associated with high blood sugar levels. Choice B focuses on weight loss, which may be beneficial but is not as critical as controlling blood sugar levels. Choice C, distributing calories throughout the day, is important for glycemic control but not as immediate as reaching a target HbA1c level. Choice D, stating the reasons for eliminating simple sugars, is a good educational goal but not as urgent as achieving glycemic control.

3. Which of the following is an example of a primary prevention strategy?

• A. Administering vaccinations
• B. Performing a surgical procedure
• C. Teaching healthy lifestyle choices
• D. Prescribing medication

Correct answer: A

Rationale: Administering vaccinations is indeed an example of a primary prevention strategy. Primary prevention aims to prevent the occurrence of a disease or injury before it occurs by targeting the entire population or specific high-risk groups. Vaccinations help prevent the initial development of a disease by enhancing immunity against specific pathogens. Choices B, C, and D are not examples of primary prevention strategies. Performing a surgical procedure (Choice B) is a treatment intervention, not a preventive measure. Teaching healthy lifestyle choices (Choice C) falls under health promotion and education, which is more aligned with secondary prevention. Prescribing medication (Choice D) is typically associated with treatment rather than preventing the initial onset of a disease.

4. There are several pitfalls that should be avoided when using social media of any type. For example, a nurse or student could be found guilty of libel in which of the following scenarios?

• A. Snapping a selfie with a patient
• B. Posting a positive review of the hospital where the student completed clinicals
• C. Creating a closed online forum where students can discuss clinical experiences without providing client information
• D. Complaining about her nurse preceptor on social media, discussing the preceptor�s unprofessional characteristics.

Correct answer: D

Rationale: Statements about individuals encountered in one�s professional or educational life that could damage that person�s reputation may be slander or libel and can be prosecuted as quasi-intentional torts.

5. What is a benefit of effective delegation?

• A. It increases the manager's workload
• B. It allows the manager to make all the decisions
• C. It empowers staff to make decisions
• D. It decreases staff involvement

Correct answer: C

Rationale: The correct answer is C: 'It empowers staff to make decisions.' Effective delegation involves entrusting tasks and decisions to staff, which not only lightens the manager's load but also empowers employees, enhancing their skills and confidence. Choice A is incorrect because effective delegation should reduce the manager's workload by distributing tasks appropriately. Choice B is incorrect as effective delegation involves empowering staff to make decisions rather than the manager making all decisions. Choice D is incorrect as effective delegation actually increases staff involvement by giving them more responsibilities and decision-making power.

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