Nursing Elites

1. The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia) through a restricted access medication program. What is most important for the nurse to report immediately to the health care provider?

• A. The patient's blood pressure is 154/92.
• B. The patient has a history of emphysema
• C. The patient's blood glucose is 86 mg/dL.
• D. The patient has chest pressure when walking

Correct answer: D

Rationale: Chest pressure while walking may indicate heart-related issues such as angina or a heart attack. Rosiglitazone (Avandia) has been associated with increased risks of cardiovascular events like heart failure. Given these risks, chest pressure is an urgent symptom that must be reported immediately to prevent potentially life-threatening complications.

2. What is the main purpose of a healthcare proxy?

• A. To manage financial affairs
• B. To make medical decisions on behalf of the patient
• C. To provide legal representation
• D. To oversee patient discharge planning

Correct answer: B

Rationale: The main purpose of a healthcare proxy is to make medical decisions on behalf of the patient when they are unable to do so. Choice A is incorrect as managing financial affairs is typically handled by a power of attorney for finances. Choice C is incorrect as a healthcare proxy is not meant to provide legal representation. Choice D is incorrect as overseeing patient discharge planning is a responsibility of healthcare providers, not a healthcare proxy.

3. A nurse is talking with the partner of a client who has dementia. The client's partner expresses frustration about finding time to manage household responsibilities while caring for their partner. The nurse should identify that the partner is experiencing which of the following types of role-performance stress?

• A. Role ambiguity
• B. Role overload
• C. Role conflict
• D. Sick role

Correct answer: C

Rationale: In this scenario, the partner is struggling to balance caring for their loved one with dementia and managing household responsibilities. This situation represents role conflict, where conflicting demands from different roles (caregiver and homemaker) create stress. Role ambiguity (choice A) refers to uncertainty about what is expected in a role, not conflicting demands. Role overload (choice B) occurs when there are too many responsibilities within a single role, not conflicting roles. The sick role (choice D) is a sociological concept related to the rights and responsibilities of individuals who are ill.

4. What is the primary responsibility of a clinical nurse leader (CNL)?

• A. Supervise nursing staff
• B. Coordinate patient care
• C. Develop nursing policies
• D. Implement evidence-based practice

Correct answer: B

Rationale: The main role of a clinical nurse leader (CNL) is to coordinate patient care. While CNLs may oversee aspects of nursing staff, the primary focus is on coordinating patient care to ensure effective treatment and outcomes. Developing nursing policies and implementing evidence-based practice are important aspects of nursing leadership but are not the main role of a CNL.

5. What is a common barrier to effective delegation?

• A. Lack of trust in team members
• B. Lack of communication
• C. Inadequate training
• D. Lack of resources

Correct answer: A

Rationale: One of the common barriers to effective delegation is a lack of trust in team members. Delegating tasks involves entrusting responsibilities to others, and without trust in the team members' capabilities, the delegator may struggle to effectively assign tasks. Trust is essential for successful delegation as it allows for empowerment and accountability within the team. While lack of communication is crucial for effective delegation, the lack of trust has a more profound impact as it directly affects the ability to delegate tasks. Inadequate training and lack of resources, although important factors, are not as fundamental as trust in team members when it comes to effective delegation.

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