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. Which of the following leaders would be considered a transformational leader?

• A. The supervisor of a unit who requests staff to work overtime.
• B. The unit secretary who encourages staff to use the proper forms.
• C. A unit manager who reminds a CNA (Certified Nursing Assistant) to work on time management skills.
• D. The Advanced Practice Nurse who encourages a staff nurse to pursue additional education for career advancement.

Correct answer: D

Rationale: The correct answer is D because transformational leaders are known for inspiring and motivating their followers to reach their full potential. They focus on fostering a positive work environment, encouraging growth, and supporting career development. In this scenario, the Advanced Practice Nurse is displaying characteristics of a transformational leader by encouraging a staff nurse to pursue additional education for career advancement. Choices A, B, and C do not align with the traits of a transformational leader as they involve more routine tasks or directives without the inspirational and visionary approach typical of transformational leadership.

3. Nurse Managers work with staff to educate them about ways to diffuse potentially violent situations. Which of the following diagnoses can staff expect to be more frequently associated with violence?

• A. Alcohol or drug withdrawal
• B. Anxiety
• C. Depression
• D. Confusion

Correct answer: A

Rationale: Alcohol or drug withdrawal is more frequently associated with violence as these conditions alter a person's inhibitions. Gilmore (2006) highlights that working with the public involves inherent risks and stressors. Individuals with head trauma, mental illnesses, and those withdrawing from substances are more likely to respond with violence. Anxiety, depression, and confusion do not typically lead to increased violent behavior compared to conditions involving substance withdrawal.

4. One of the steps in coaching is often overlooked and taken for granted. What is this step?

• A. Stating the target
• B. Jumping to conclusions
• C. Asking for suggestions
• D. Tying the problem to clients' care

Correct answer: D

Rationale: In coaching, tying the problem to clients' care is crucial but often overlooked. This step ensures that the coach and the client focus on issues directly impacting the client's well-being. Stating the target (choice A) is important but not as critical as tying the problem to clients' care. Jumping to conclusions (choice B) is counterproductive in coaching as it may lead to incorrect assumptions. Asking for suggestions (choice C) is valuable, but it does not address the core aspect of linking the issue to the client's care, which is essential for effective coaching.

5. 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: Complaining about her nurse preceptor on social media, discussing the preceptor�s unprofessional characteristics, could be considered libel.

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