Nursing Elites

1. An RN�s current patient and family have presented her with an ethical dilemma. What is the first step the RN should take to find a workable solution to the problem?

• A. Planning
• B. Assessment
• C. Evaluation
• D. Implementation

Correct answer: B

Rationale: The first step the RN should take to find a workable solution to the problem is assessment.

2. A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about

• A. self-monitoring of blood glucose
• B. using low doses of regular insulin
• C. lifestyle changes to lower blood glucose
• D. effects of oral hypoglycemic medications

Correct answer: C

Rationale: When a patient has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L), indicating prediabetes, the initial approach is focused on lifestyle modifications to lower blood glucose levels. These changes may include dietary adjustments, increased physical activity, and weight management. Self-monitoring of blood glucose, insulin therapy, and oral hypoglycemic medications are not typically the first-line interventions for patients with prediabetes. Educating the patient about lifestyle changes to lower blood glucose is the most appropriate action at this stage.

3. A nurse supervisor is planning an educational session for her staff regarding improving teamwork among different generations. Which of the following recommendations will reduce potential generational conflicts?

• A. Involve only millennials in technology decisions.
• B. Focus on the team as a whole, rather than individual generations.
• C. Involve only the baby boomers in technology decisions.
• D. Practice active and assertive communication techniques.

Correct answer: D

Rationale: Active and assertive communication will assist each generation to value the others� skills and perspectives.

4. Which of the following is an example of total time lost?

• A. Number of days off that an employee asks for
• B. Number of scheduled days missed
• C. Number of days missed
• D. Number of days perceived to be absent

Correct answer: B

Rationale: The correct answer is B. Total time lost refers to the number of scheduled days that an employee misses. This includes days that were planned to be worked but were not. Choice A, 'Number of days off that an employee asks for,' is not necessarily time lost as these are approved absences. Choice C, 'Number of days missed,' is vague and does not specify if they are scheduled or unscheduled. Choice D, 'Number of days perceived to be absent,' is subjective and does not clearly relate to scheduled time lost.

5. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?

• A. Ask the client to consider a direct donation
• B. Withhold the blood transfusion
• C. Ask the client to consider a direct donation
• D. Request a consultation with the ethics committee

Correct answer: A

Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.

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