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 nurse is discussing the responsibility of caring for clients with clostridium difficile infection. Which of the following information should the nurse include in the teaching?

• A. Have family members wear a gown and gloves when visiting.
• B. Clean contaminated surfaces in the client's room with a bleach solution.
• C. Use alcohol-based hand sanitizer when leaving the client's room.
• D. Assign the client to a room with a private bathroom.

Correct answer: A

Rationale: When caring for clients with clostridium difficile infection, it is important to prevent the spread of the bacteria. Having family members wear a gown and gloves when visiting helps reduce the risk of transmission. Cleaning contaminated surfaces with a bleach solution, not phenol, is recommended to effectively kill the C. difficile spores. Using alcohol-based hand sanitizer is not sufficient, as it may not be effective against C. difficile spores. Assigning the client to a room with a private bathroom is more beneficial than a negative airflow system, as it helps prevent the spread of bacteria to other clients.

3. Which of the following may be considered an absenteeism management strategy?

• A. Holding regular meetings to address absenteeism
• B. Limiting career growth opportunities
• C. Reducing job stress
• D. Neglecting the issue

Correct answer: C

Rationale: Reducing job stress is an effective absenteeism management strategy because it creates a positive work environment, potentially decreasing the number of sick days taken by employees. Holding regular meetings to address absenteeism is not a strategy to reduce absenteeism but may add to the stress levels of employees. Limiting career growth opportunities is not a recommended strategy and can lead to employee dissatisfaction and higher absenteeism rates. Neglecting the issue of absenteeism by ignoring it can exacerbate the problem and create a negative work culture.

4. A nurse is planning care of an adolescent who is postoperative following a lumbar laminectomy. Which of the following interventions should the nurse include in the plan of care?

• A. Limit the adolescent's visitors.
• B. Select the adolescent's food choices.
• C. Encourage the adolescent's guardian to assist with personal hygiene.
• D. Allow the adolescent to make decisions regarding their daily routine.

Correct answer: C

Rationale: The correct answer is C because after a lumbar laminectomy, the adolescent may need assistance with personal hygiene due to limited mobility and pain. Encouraging the guardian to assist with personal hygiene ensures proper care and prevents complications. Choice A is incorrect as limiting visitors may affect the adolescent's emotional well-being and support system. Choice B is incorrect as the adolescent should have autonomy in selecting their food choices as long as they align with their dietary restrictions post-surgery. Choice D is incorrect as the adolescent may need guidance and support in decision-making during the postoperative period.

5. What is the primary responsibility of a clinical nurse leader (CNL)?

• A. Supervise nursing staff
• B. Coordinate patient care
• C. Develop nursing policies
• D. Implement evidence-based practice

Correct answer: B

Rationale: The main role of a clinical nurse leader (CNL) is to coordinate patient care. While CNLs may oversee aspects of nursing staff, the primary focus is on coordinating patient care to ensure effective treatment and outcomes. Developing nursing policies and implementing evidence-based practice are important aspects of nursing leadership but are not the main role of a CNL.

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