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1. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?
- A. Teach the patient about administering regular insulin.
- B. Schedule the patient for a fasting blood glucose level.
- C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
- D. Provide teaching about an increased risk for fetal problems with gestational diabetes.
Correct answer: B
Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.
2. 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.
3. A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to
- A. save the lunch tray for the patient�s later return to the unit
- B. ask that diagnostic testing area staff to start a 5% dextrose IV
- C. send a glass of milk or orange juice to the patient in the diagnostic testing area
- D. request that if testing is further delayed, the patient be returned to the unit to eat.
Correct answer: D
Rationale:
4. A female patient is scheduled for an oral glucose tolerance test. Which information from the patient�s health history is most important for the nurse to communicate to the health care provider?
- A. The patient uses oral contraceptives.
- B. The patient runs several days a week.
- C. The patient has been pregnant three times
- D. The patient has a family history of diabetes
Correct answer: A
Rationale:
5. A Staff Nurse submits a six-week notice of resignation. The Nurse Manager prepares a request to immediately post the position and begin interviews. This action is best described as which of the following?
- A. Delegation
- B. A time-waster
- C. Reactive management
- D. Proactive management
Correct answer: D
Rationale: The correct answer is D, Proactive management. Proactive management involves taking steps to prevent issues from occurring rather than just reacting to them. In this scenario, the Nurse Manager is being proactive by preparing to fill the position before the Staff Nurse leaves, thereby preventing short staffing. Choices A, B, and C are incorrect. Delegation refers to assigning tasks to others, not preparing to fill a vacant position. Calling it a time-waster is subjective and not reflective of the manager's proactive approach. Reactive management would involve waiting until the Nurse leaves and then trying to fill the position, causing short staffing.
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