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 registered nurse (RN) administered a patient�s morning insulin as the breakfast tray arrived at 0800. The RN performed a complete assessment at the same time. Then, the RN got busy with her other patients and did not check on the patient until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. Which of the following could the RN be charged with?

• A. Quasi-intentional tort
• B. Misdemeanor
• C. Negligence
• D. Juvenile offense

Correct answer: C

Rationale: The RN could be charged with negligence.

3. The process by which registered nurses assess and judge the performance of peers against some predetermined standard is called:

• A. Group evaluation.
• B. Peer review.
• C. Forced distribution evaluation.
• D. Essay evaluation.

Correct answer: B

Rationale: The correct answer is B: Peer review. Peer review is a process in which professional peers assess and judge the performance of their colleagues against predetermined standards. Essay evaluations involve describing an employee's performance through a detailed written narrative. Forced distribution evaluation is a method where employees are rated based on a fixed distribution, similar to grading on a curve. Group evaluation, on the other hand, involves managers comparing individual and group performance against organizational standards.

4. Which of the following is used as an indirect estimate of voluntary absenteeism?

• A. Involuntary absenteeism
• B. Voluntary absenteeism
• C. Total time lost
• D. Absence frequency

Correct answer: D

Rationale: The correct answer is 'Absence frequency.' Absence frequency is the total number of distinct absence periods, regardless of duration. It is used as an indirect estimate of voluntary absenteeism because it provides insights into the frequency of absences. Voluntary absenteeism refers to absences that are under the employee's control, while involuntary absenteeism is not under their control. Total time lost, on the other hand, represents the number of scheduled days that employees miss, which is different from absence frequency.

5. Which of the following best describes the role of a nurse case manager?

• A. To provide direct patient care
• B. To manage healthcare facilities
• C. To advocate for patient rights
• D. To coordinate long-term care services

Correct answer: D

Rationale: The correct answer is D: 'To coordinate long-term care services.' A nurse case manager's primary role is to coordinate and manage long-term care services for patients, ensuring continuity and quality of care. Choice A is incorrect because providing direct patient care is typically the responsibility of nurses, not nurse case managers. Choice B is incorrect as managing healthcare facilities is a role usually fulfilled by healthcare administrators. Choice C is incorrect as advocating for patient rights is important but not the primary role of a nurse case manager.

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