Nursing Elites

1. 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.

2. A recent nursing school graduate is preparing to take the NCLEX. The graduate knows which of the following is true?

• A. Upon graduation from nursing school, she cannot use the title RN.
• B. Because the NCLEX is a national examination, her RN license will allow her to practice in all states and territories of the United States.
• C. If her home state participates in the compact agreement, she may practice in other states participating in the agreement, but should renew her license in her home state.
• D. The RN license is a mandatory license.

Correct answer: C

Rationale: Choice C is correct because if the nurse's home state participates in the compact agreement, she can practice in other states that are part of the agreement, but she must still renew her license in her home state. This is necessary to maintain an active license in her home state. Choice A is incorrect because upon graduation, the nurse can use the title RN if licensed, but it's not automatic. Choice B is incorrect because while the NCLEX is a national exam, the nurse needs to meet individual state requirements for licensure in each state. Choice D is incorrect because an RN license is not permissive but rather a mandatory license to practice nursing.

3. What is the best description of cultural competence in nursing?

• A. Ignoring cultural differences
• B. Adapting care to cultural needs
• C. Learning about different cultures
• D. Teaching cultural awareness

Correct answer: B

Rationale: Cultural competence in nursing means adapting care to meet the cultural needs of patients. This involves understanding and respecting the cultural differences of individuals to provide effective and appropriate healthcare. Choice A is incorrect because ignoring cultural differences goes against the essence of cultural competence. Choice C is not the best description as cultural competence is more than just learning about different cultures; it is about applying that knowledge in providing care. Choice D is not the best description as teaching cultural awareness is only a part of developing cultural competence, but it also requires practical application in care delivery.

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. What term refers to the situation where the pay of newer employees is similar to or higher than that of more experienced employees?

• A. Salary compression
• B. Salary expectations
• C. Salary range
• D. Salary inflation

Correct answer: A

Rationale: Salary compression is the term used to describe the situation where the pay of newer employees is similar to or higher than that of more experienced employees. This can happen when newer employees are paid higher salaries to attract them, leading to a compressed salary structure in the organization. Choice B, 'Salary expectations,' does not specifically refer to the scenario described in the question. Choice C, 'Salary range,' is a broader term referring to the range of salaries offered for a particular job or position, not specifically related to the disparity between new and experienced employees. Choice D, 'Salary inflation,' does not accurately describe the situation of newer employees earning higher salaries than more experienced ones; instead, it refers to a general increase in wages across the board.

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