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. What is the main goal of a nursing quality improvement (QI) program?

• A. To enhance patient safety
• B. To reduce healthcare costs
• C. To ensure regulatory compliance
• D. To maintain high patient satisfaction

Correct answer: A

Rationale: The main goal of a nursing quality improvement (QI) program is to enhance patient safety. While reducing healthcare costs, ensuring regulatory compliance, and maintaining high patient satisfaction are important aspects of healthcare delivery, the primary focus of a QI program in nursing is to improve patient safety through practices such as error reduction, risk management, and enhancing the quality of care provided.

3. Which of the following theories explains that organizations are made up of intertwined links and diversified choices that generate unanticipated consequences?

• A. Contingency theory
• B. Closed system theory
• C. Open system theory
• D. Chaos theory

Correct answer: D

Rationale: The chaos theory explains that organizations are made up of intertwined links and diversified choices that generate unanticipated consequences. Choice A, Contingency theory, focuses on how organizations adapt to their environment. Choice B, Closed system theory, suggests that organizations are self-contained and do not interact with their environment. Choice C, Open system theory, emphasizes that organizations interact with their environment but does not specifically address intertwined links and diversified choices generating unanticipated consequences.

4. The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select ONE that does not apply.)

• A. Expected length of stay
• B. Assigned staff healthcare provider
• C. Patient outcomes
• D. Medical diagnosis

Correct answer: B

Rationale: Critical pathways are designed to outline the expected sequence and timing of interventions to achieve optimal patient outcomes for a specific medical condition. Components such as the expected length of stay, patient outcomes, and medical diagnosis are crucial in developing a critical pathway for congestive heart failure. However, the assigned staff healthcare provider is not typically a fixed component of a critical pathway as it may vary based on staffing schedules and rotations. Therefore, the assigned staff healthcare provider is the component that does not apply.

5. Which of the following types of leadership behaviors would be most useful when managing a staff of newly trained CNAs (Certified Nursing Assistants)?

• A. Achievement-oriented
• B. Supportive
• C. Participative
• D. Directive

Correct answer: D

Rationale: The most useful type of leadership behavior when managing a staff of newly trained CNAs (Certified Nursing Assistants) would be directive. Directive leadership involves giving specific guidance, ensuring adherence to rules and procedures, scheduling work efforts, and clearly telling employees what is expected. This approach is particularly beneficial for newly trained staff who may require clear instructions and guidance. - Achievement-oriented leadership focuses on setting challenging goals and encouraging employees to reach their highest potential. While this can be beneficial in some situations, it may not be the most suitable for managing newly trained CNAs who require more guidance and direction. - Supportive leadership involves providing emotional support, encouragement, and assistance to employees. While emotional support is essential in any work environment, newly trained CNAs may benefit more from clear direction and guidance. - Participative leadership involves involving employees in decision-making processes. While this can promote employee engagement and empowerment, newly trained CNAs may require more structured guidance and direction to ensure they understand their roles and responsibilities.

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