Nursing Elites

1. An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?

• A. Hemoglobin A1C level 6.2%
• B. Blood pressure 146/88 mmHg
• C. Heart rate at rest 58 beats/minute
• D. High-density lipoprotein (HDL) level 65 mg/dL

Correct answer: B

Rationale: The correct answer is B. In a young adult with type 1 diabetes, a blood pressure of 146/88 mmHg may indicate the need for a change in therapy as it is above the recommended target levels. High blood pressure can increase the risk of cardiovascular complications in diabetic patients. Choices A, C, and D are within normal ranges and do not necessarily indicate the need for an immediate change in therapy. A Hemoglobin A1C level of 6.2% is generally considered good control for a diabetic patient, a resting heart rate of 58 beats/minute is normal for an active individual, and an HDL level of 65 mg/dL is considered to be in the desirable range for heart health.

2. A staff nurse describes the unit manager as 'a born leader.' The nurse ascribes to which theory of leadership?

• A. Trait theories
• B. Behavioral theories
• C. Formal leadership theories
• D. Democratic leadership theories

Correct answer: A

Rationale: The correct answer is A: Trait theories. The nurse describing the unit manager as 'a born leader' aligns with trait theories of leadership, which suggest that certain inborn characteristics or traits contribute to effective leadership. This theory emphasizes that leaders possess natural qualities that make them suitable for leadership roles. Choices B, C, and D are incorrect. Behavioral theories focus on the actions and behaviors of leaders, formal leadership theories emphasize organizational structure and roles, and democratic leadership theories pertain to a style of leadership that involves participative decision-making.

3. 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.

4. A client with limited mobility in their lower extremities is at risk for skin breakdown. Which of the following actions should the nurse take to prevent skin breakdown?

• A. Place the client in high-Fowler's position.
• B. Increase the client's intake of carbohydrates.
• C. Massage areas of skin that are darker than the surrounding skin tissue with unscented lotion.
• D. Have the client use a trapeze bar when changing position

Correct answer: B

Rationale: The correct answer is B: Increase the client's intake of carbohydrates. Adequate nutrition, including carbohydrates, is essential for tissue repair and preventing skin breakdown. Placing the client in high-Fowler's position (choice A) may help with respiratory function but does not directly prevent skin breakdown. Massaging areas of darker skin (choice C) can cause further damage to the skin. Using a trapeze bar (choice D) may assist with changing positions but does not directly address skin breakdown prevention.

5. Healthcare systems primarily have functional structures. Which of the following would be an example of this?

• A. Open communication exists between Physical Therapy and Nursing.
• B. Medicine has authority over nursing.
• C. Laboratory services have little authority.
• D. All nursing tasks fall under nursing service.

Correct answer: D

Rationale: The correct answer is D. In functional structures, employees are grouped in departments by specialty, with similar tasks being performed by the same group. This means that in a healthcare system with a functional structure, all nursing tasks would fall under the nursing service. Choices A, B, and C are incorrect because open communication between departments, one department having authority over another, or the level of authority of a particular department do not necessarily represent a functional structure.

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