Nursing Elites

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. The nurse manager is talking with the CNA about her time management. Which of the following is an example of a nurse manager as a coach?

• A. Your timely response to patients' call lights is exemplary.
• B. Your appearance is seldom professional.
• C. You must get the vital signs taken on time or you will be disciplined.
• D. You never report AM blood sugar levels on time.

Correct answer: A

Rationale: The correct answer is A: 'Your timely response to patients' call lights is exemplary.' This choice reflects a positive reinforcement approach, providing feedback that praises and encourages good behavior. A coach in a professional setting aims to motivate, guide, and support staff rather than focusing on negative aspects or threats of discipline. Effective coaching involves recognizing and acknowledging employees' strengths and achievements to inspire continuous improvement and development. Choices B, C, and D are not examples of coaching as they either focus on criticism regarding appearance, use threatening language, or highlight a negative behavior without offering guidance or support.

3. What is the primary purpose of clinical pathways in healthcare?

• A. Reduce hospital readmissions
• B. Standardize care
• C. Provide individualized care
• D. Streamline care processes

Correct answer: C

Rationale: The primary purpose of clinical pathways in healthcare is to provide individualized care. While clinical pathways do involve standardizing treatment plans, their main goal is to tailor these plans to the individual needs of patients. This customization ensures that patients receive care that is specific to their condition and requirements, rather than a one-size-fits-all approach. Choices A, B, and D are incorrect because although reducing hospital readmissions, standardizing care, and streamlining care processes can be benefits of clinical pathways, they are not the primary purpose. The main focus is on delivering personalized treatment paths to enhance patient outcomes.

4. Which of the following best describes the concept of shared governance?

• A. Top-down management
• B. Nurse-led committees
• C. Shared decision making
• D. Hierarchical structure

Correct answer: C

Rationale: The correct answer is C: 'Shared decision making.' Shared governance in healthcare involves empowering nurses to participate in decision-making processes that affect their practice. This model fosters collaboration, transparency, and accountability among healthcare providers. Choice A, 'Top-down management,' is incorrect because shared governance promotes a bottom-up approach. Choice B, 'Nurse-led committees,' is partially correct as it is a component of shared governance, but the core concept is broader and encompasses shared decision making beyond committee leadership. Choice D, 'Hierarchical structure,' is incorrect as shared governance aims to flatten hierarchies and distribute decision-making authority among healthcare team members.

5. The ANA is a registered labor organization, but it does not engage in direct __________.

• A. Empower union affiliation
• B. Reward union affiliation
• C. Encourage union affiliation
• D. Collective bargaining

Correct answer: D

Rationale: The correct answer is D, 'Collective bargaining.' The American Nurses Association is a registered labor organization, but it does not engage in direct collective bargaining. The actual certification of units, negotiation of contracts, and administration of contracts is conducted by the state nurses associations (SNAs). Choices A, B, and C are incorrect as the ANA's role does not involve empowering, rewarding, or encouraging union affiliation directly.

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