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. A new nurse is thinking about the ways she can demonstrate leadership in her position. Which of the following is true about leadership?

• A. Leadership is a component of nursing practice.
• B. Leadership requires a position of oversight.
• C. Leadership depends on the actions of others.
• D. Only experienced nurses can demonstrate leadership.

Correct answer: A

Rationale: The correct answer is A: 'Leadership is a component of nursing practice.' Leadership is an essential aspect of nursing practice that involves inspiring, guiding, and influencing others to achieve common goals. Choice B is incorrect because leadership can be demonstrated at various levels within an organization, not just positions of oversight. Choice C is incorrect as leadership involves taking initiative and guiding others, rather than depending solely on the actions of others. Choice D is incorrect as leadership qualities can be demonstrated by individuals at all levels of experience, not exclusively by experienced nurses.

3. A client complains every morning that the night shift nursing staff does not answer his call light promptly to assist his elimination needs. His concerns are not shared with the Nurse Manager, and he falls while trying to walk to the bathroom. This fall could be attributed to which of the following?

• A. Breakdown in communication
• B. Lack of staff
• C. Lack of concern
• D. Breakdown in management

Correct answer: A

Rationale: The correct answer is A: Breakdown in communication. In this scenario, the client's complaints about the night shift nursing staff not responding promptly to his call light indicate a lack of effective communication. If the client's concerns were properly communicated to the Nurse Manager, steps could have been taken to address the issue and prevent the fall. Choice B, Lack of staff, is incorrect as the issue here is not related to staffing levels but rather to communication breakdown. Choice C, Lack of concern, is not the primary cause of the fall; the root cause lies in communication failure. Choice D, Breakdown in management, while related, is not as direct a cause as the breakdown in communication which led to the fall.

4. What is the main focus of a clinical governance framework?

• A. Financial performance
• B. Regulatory compliance
• C. Patient care quality
• D. Staff satisfaction

Correct answer: C

Rationale: The main focus of a clinical governance framework is patient care quality. This framework is designed to ensure that patient care is safe, effective, and patient-centered. Choice A, financial performance, is not the main focus of a clinical governance framework, although financial aspects may be considered. Choice B, regulatory compliance, is important but not the primary focus of a clinical governance framework. Choice D, staff satisfaction, is also important but is not the main focus of a clinical governance framework, which primarily centers around patient care quality.

5. Your values do not coincide with your colleagues. When you report for your shift on nights and staff are not responding to patient requests for pain medication, you, as the nurse responsible for collecting data about patient quality of care, should:

• A. Explain to the nurse manager that quality problems are because of staff apathy.
• B. Issue a memo to staff to assess patients and document their response to the pain medication.
• C. Explain to staff that improving quality is one of your annual goals and you expect them to follow through.
• D. Schedule meetings to engage with staff to monitor pain management.

Correct answer: D

Rationale: As the nurse responsible for collecting data about patient quality of care, it is important to address the issue of staff not responding to patient requests for pain medication. Scheduling meetings to engage with staff to monitor pain management is the most appropriate course of action in this scenario. By enlisting support from staff, reviewing patient satisfaction data, and quality reports about pain management, you can effectively address the issue and improve patient care. Choices A, B, and C are not as effective as they do not involve actively engaging with staff, reviewing data, and working collaboratively to address the problem.

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