Nursing Elites

1. One of the perceptions of turnover is:

• A. Poor management
• B. Rejection of the job
• C. Loss of poor performers
• D. Poor job atmosphere

Correct answer: B

Rationale: The correct answer is B: 'Rejection of the job.' According to Steers and Stone, turnover can be perceived by coworkers as a rejection of the job. Choice A, 'Poor management,' is incorrect because turnover perception is more related to individual feelings about the job rather than management. Choice C, 'Loss of poor performers,' is incorrect as it focuses on the outcome of turnover rather than the perception. Choice D, 'Poor job atmosphere,' is incorrect as it describes a cause of turnover rather than a perception.

2. Characteristics that an interviewer will be most interested in when selecting a new staff will be: (EXCEPT)

• A. Your confidence in your clinical skills.
• B. How many hours of overtime you will work.
• C. Your ability to work as a team member.
• D. Your clinical competence.

Correct answer: B

Rationale: The correct answer is B. When selecting new staff, interviewers are primarily interested in candidates' confidence in clinical skills, ability to work as a team member, and clinical competence. They are not concerned with how many hours of overtime a candidate is willing to work. Overtime hours may be important at times, but it is not a characteristic that an interviewer would prioritize when selecting new staff. Choices A, C, and D are essential qualities that interviewers look for in potential staff as they contribute to providing professional nursing care.

3. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?

• A. Hemoglobin A1C level is 7.9%.
• B. Last eye exam was 18 months ago.
• C. Glomerular filtration rate is decreased.
• D. Patient has questions about the prescribed diet.

Correct answer: C

Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.

4. 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.

5. A ___________ manager supervises a number of first-level managers, usually within related specialties.

• A. self-directed
• B. first-level
• C. middle-level
• D. self-motivated

Correct answer: C

Rationale: A middle-level manager is responsible for overseeing a group of first-level managers who handle day-to-day operations within their respective specialties. Middle-level managers play a crucial role in coordinating and aligning the efforts of multiple first-level managers to achieve organizational goals. They act as a bridge between top management and frontline employees, ensuring that strategies are effectively implemented at the operational level. Choice A, 'self-directed,' refers to an individual's ability to manage their own work without direct supervision and does not specifically relate to supervising other managers. Choice B, 'first-level,' describes the managers being supervised, not the position responsible for overseeing them. Choice D, 'self-motivated,' pertains to an individual's drive and determination, which is not directly related to the hierarchical level of management being discussed.

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