Nursing Elites

1. Horizontal violence may be observed among staff interactions and causes stress among staff. To minimize stress associated with such interactions, nurses can: (Select all that apply.)

• A. Encourage venting as a way to express feelings.
• B. Take control of the situation by being assertive.
• C. Ignore staff who are volatile.
• D. Avoid interactions with angry staff.

Correct answer: B

Rationale: To minimize stress associated with horizontal violence among staff interactions, nurses should take control of the situation by being assertive. Being assertive allows nurses to address the issues causing stress in a constructive and professional manner. Encouraging venting without addressing the underlying problems may not resolve the situation effectively. Ignoring staff who are volatile can escalate the issue further, and avoiding interactions with angry staff does not address the root cause of the problem. Therefore, being assertive and addressing the situation directly is the most effective approach to minimize stress and promote a healthy work environment.

2. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?

• A. BUN 21 mg/dL (10 to 20 mg/dL)
• B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
• C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
• D. Sodium 132 mEq/L (136 to 145 mEq/L)

Correct answer: B

Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.

3. What is the main purpose of the NCLEX examination?

• A. Ensure that individuals have passed nursing classes.
• B. Provide assurance that nursing schools are part of the service agency.
• C. Enable potential students to determine the best nursing schools.
• D. Ensure the safety of the public.

Correct answer: D

Rationale: The main purpose of the NCLEX examination is to ensure the safety of the public by determining if candidates have the knowledge and skills necessary to provide safe and effective nursing care. Choice A is incorrect as the exam evaluates if individuals are ready to begin nursing practice, not just passed classes. Choice B is incorrect as the exam is not related to the affiliation of nursing schools with service agencies. Choice C is incorrect as the exam is not designed to help potential students choose the best nursing schools, but rather to assess individual readiness for nursing practice to protect public safety.

4. Penalties should be __________ .

• A. Determining the employee's awareness of the policy
• B. Describing the staff nurse's behavior that violated the policy
• C. Progressive
• D. Confrontation

Correct answer: C

Rationale: Penalties for policy violations should be progressive. This means that the disciplinary actions should escalate based on the severity or frequency of the violation. For minor infractions, like smoking in an unauthorized area, a progressive approach may include oral warnings, written warnings, suspension, and termination if the behavior persists. In contrast, major violations, such as theft, may warrant immediate and severe consequences like suspension or termination. Choices A, B, and D are incorrect as they do not address the concept of progressively escalating penalties based on the violation's severity or recurrence.

5. Selye's stress theory explains that a person stressed for long periods of time will:

• A. Face exhaustion and be more susceptible to illnesses.
• B. Become fatigued and become stronger.
• C. Become more assertive.
• D. Safety needs.

Correct answer: A

Rationale: Selye's stress theory posits that individuals experiencing prolonged stress are likely to face exhaustion and become more susceptible to illnesses. This is because the body's response to chronic stress can lead to physical and psychological depletion, increasing the risk of health problems. Choice B is incorrect as becoming stronger is not a typical outcome of prolonged stress according to Selye's theory. Choice C, becoming more assertive, is not directly related to the physical implications of chronic stress. Choice D, safety needs, is unrelated to Selye's stress theory and does not reflect the expected outcomes of prolonged stress.

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