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. The manager of a medical-surgical unit is very task-motivated. Using Fiedler's Contingency Theory, under what circumstances would the manager be most effective?

• A. Only during highly stressful situations.
• B. When there is little to no stress.
• C. Under highly structured situations.
• D. When the situation is loosely structured.

Correct answer: C

Rationale: According to Fiedler's Contingency Theory, task-motivated managers are most effective under highly structured situations. This is because in such environments, where priorities are clear and tasks are well-defined, task-oriented managers can excel in organizing and accomplishing objectives efficiently. Choices A and B are incorrect because the effectiveness of a task-motivated manager is not solely linked to stress levels but rather to the structure of the situation. Choice D is also incorrect as a loosely structured situation would not provide the clarity and direction that a task-motivated manager thrives in.

3. Which of the following are managerial functions, according to Mintzberg? (EXCEPT)

• A. Leading and linking at the people level
• B. Communicating and controlling at the information level
• C. Deciding pay structures
• D. Doing at the action level

Correct answer: C

Rationale: The correct answer is C. Mintzberg believed that managing involves communicating and controlling at the information level, leading and linking at the people level, and doing at the action level. Choice A is correct as it aligns with Mintzberg's concept of leading and linking at the people level. Choice B is correct as it aligns with Mintzberg's concept of communicating and controlling at the information level. Choice D is correct as it aligns with Mintzberg's concept of doing at the action level. Choice C, deciding pay structures, is not a managerial function according to Mintzberg's model, making it the exception.

4. Which of the following best describes the concept of just culture in a healthcare organization?

• A. A culture of blaming individuals for mistakes
• B. A culture of encouraging reporting and learning from errors
• C. A culture of punishing individuals for errors
• D. A culture of ignoring errors

Correct answer: B

Rationale: Just culture in a healthcare organization promotes a blame-free environment where individuals are encouraged to report errors and focus on learning from them to improve patient safety and quality of care. Choice A is incorrect as just culture does not involve blaming individuals. Choice C is incorrect as it goes against the principles of just culture by advocating for punishment rather than learning. Choice D is incorrect as just culture aims to address errors constructively rather than ignore them.

5. What is the term used for assigning a rating based on an overall impression?

• A. Recency error.
• B. Leniency error.
• C. Absolute judgment.
• D. Halo error.

Correct answer: D

Rationale: The correct answer is 'Halo error.' Halo error occurs when a rating is given based on a general impression rather than specific performance criteria. Choice A, 'Recency error,' refers to rating an employee based on recent events rather than the entire evaluation period. Choice B, 'Leniency error,' is when a manager consistently rates employees higher than they deserve. Choice C, 'Absolute judgment,' involves evaluating based on established standards rather than an overall impression.

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