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 purpose of a clinical audit?

• A. To measure patient satisfaction
• B. To evaluate the effectiveness of clinical practices
• C. To identify areas for improvement
• D. To standardize patient care protocols

Correct answer: C

Rationale: The main purpose of a clinical audit is to identify areas for improvement in clinical practices. While patient satisfaction might be a component evaluated during an audit, the primary goal is to ensure that care is safe, effective, and patient-centered, rather than solely focusing on satisfaction. Evaluating the effectiveness of clinical practices is a related but more specific goal compared to the broader aim of identifying areas for improvement. Standardizing patient care protocols can be a result of a clinical audit, but it is not the main purpose, which is to pinpoint areas needing enhancement.

3. When utilizing an internal float pool, which of the following pools is most efficient?

• A. Centralized
• B. Flexible
• C. Mixed
• D. Decentralized

Correct answer: A

Rationale: Centralization is the most efficient option when utilizing an internal float pool because it allows for a pool of nurses to be used anywhere in the hospital. In centralized pools, staff members are not limited to working for only one nurse manager or on only one unit, unlike in decentralized pools. Flexible and mixed pools may offer some advantages, but in terms of efficiency and utilization of resources, centralized pools are the most effective choice.

4. A nurse manager is considering the variances of the budget. Fewer monies were spent than expected. What type of variance is this?

• A. Unfavorable variance
• B. Favorable variance
• C. Dependent variance
• D. Independent variance

Correct answer: B

Rationale: The correct answer is B, favorable variance. When fewer funds are spent than expected, it indicates efficient budget management, making it a favorable outcome. Choice A, unfavorable variance, is incorrect as it would apply if more money than expected was spent. Choices C and D, dependent variance and independent variance, are unrelated terms in the context of budget variances and do not apply to the situation described.

5. An expensive variable in salary budgets is overtime pay. Which of the following is a viable option to reduce overtime?

• A. Limiting overtime for highly paid workers
• B. Reducing the number of beds
• C. Using per diem workers
• D. Refusing to pay overtime

Correct answer: C

Rationale: The correct answer is C: Using per diem workers. By utilizing per diem workers, organizations can flexibly adjust staffing levels based on demand without incurring overtime costs. This approach helps in managing overtime budgets effectively. Choice A is incorrect because limiting overtime for highly paid workers may not address the root cause of overtime expenses. Choice B is incorrect as reducing the number of beds does not directly impact overtime costs. Choice D is not a practical solution as refusing to pay overtime can lead to legal issues and employee dissatisfaction.

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