Nursing Elites

1. One of the steps in coaching is often overlooked and taken for granted. What is this step?

• A. Stating the target
• B. Jumping to conclusions
• C. Asking for suggestions
• D. Tying the problem to clients' care

Correct answer: D

Rationale: In coaching, tying the problem to clients' care is crucial but often overlooked. This step ensures that the coach and the client focus on issues directly impacting the client's well-being. Stating the target (choice A) is important but not as critical as tying the problem to clients' care. Jumping to conclusions (choice B) is counterproductive in coaching as it may lead to incorrect assumptions. Asking for suggestions (choice C) is valuable, but it does not address the core aspect of linking the issue to the client's care, which is essential for effective coaching.

2. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

• A. Avoid snacking at bedtime.
• B. Increase the rapid-acting insulin dose.
• C. Check the blood glucose during the night.
• D. Administer a larger dose of long-acting insulin.

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

3. When planning care for a client with vision loss, which of the following interventions should the nurse include in the plan of care to assist the client with feeding?

• A. Arrange food in a consistent pattern on the client's plate
• B. Thicken liquids on the client's tray
• C. Provide small-handled utensils for the client
• D. Assign a staff member to feed the client

Correct answer: A

Rationale: When a client has vision loss, arranging food in a consistent pattern on the plate can help them locate and identify different food items more easily. This intervention promotes independence and allows the client to feed themselves with greater ease. Thicking liquids on the tray, providing small-handled utensils, or assigning a staff member to feed the client may not directly address the client's need for assistance with feeding due to vision loss. Thicking liquids is more related to swallowing difficulties, providing small-handled utensils can be helpful for clients with limited dexterity, and assigning a staff member to feed the client may not promote independence.

4. In order to minimize or avoid negative outcomes as a result of the violation and disciplinary action, the employee should offer which of the following?

• A. Excuses
• B. Discipline
• C. Suggestions
• D. Rules

Correct answer: C

Rationale: In order to minimize or avoid negative outcomes resulting from a violation and disciplinary action, the employee should offer suggestions. By providing suggestions, the employee demonstrates a willingness to improve and prevent future occurrences. Offering excuses (choice A) may deflect responsibility and not address the issue at hand. Discipline (choice B) is the action taken by the employer, not the employee. Rules (choice D) are guidelines to follow, but in this context, offering suggestions for improvement is more relevant.

5. What is the primary goal of patient education?

• A. To enhance clinical skills
• B. To ensure patient safety
• C. To empower patients to take control of their health
• D. To improve patient compliance

Correct answer: C

Rationale: The correct answer is C: 'To empower patients to take control of their health.' Patient education aims to provide individuals with the knowledge and skills necessary to actively participate in managing their health conditions. Choice A, 'To enhance clinical skills,' is incorrect as patient education focuses on empowering patients, not enhancing healthcare providers' skills. Choice B, 'To ensure patient safety,' is incorrect because while patient safety is crucial, the primary goal of patient education is to empower patients. Choice D, 'To improve patient compliance,' is also incorrect as the main aim is to empower patients to make informed decisions and take an active role in their healthcare.

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