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. Which of the following is one important factor in sustaining employee satisfaction?

• A. Organization culture
• B. Individual performance
• C. Performance evaluation
• D. Job satisfaction

Correct answer: D

Rationale: Job satisfaction is a crucial factor in sustaining employee satisfaction. Studies have shown that higher levels of job satisfaction lead to lower turnover rates and higher productivity. Choice A, organization culture, is important but focuses more on the overall environment rather than individual satisfaction. Choice B, individual performance, is relevant but doesn't directly address employee satisfaction. Choice C, performance evaluation, is a process rather than a factor in sustaining satisfaction.

3. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

4. A nurse is caring for a client who is scheduled to be transferred to a long-term care facility. The client's family questions the nurse about the reasons for the transfer. Which of the following responses made by the nurse is appropriate?

• A. The transfer of your family member is being done because the provider knows what's best.
• B. Would you like us to discuss the transfer with your family member?
• C. Why are you so concerned about this transfer?
• D. I know how you feel. My parent had to be transferred to a long-term care facility.

Correct answer: A

Rationale: The correct response is A because it provides a professional and reassuring explanation for the transfer, focusing on the expertise of the healthcare provider. Choice B offers to include the family member in the discussion, which may not address their concerns directly. Choice C appears defensive and does not address the family's inquiry. Choice D shifts the focus to the nurse's personal experience, which may not be relevant or helpful to the family seeking information about their own situation.

5. If a staff member does not respond to discipline, the manager must ______ employment.

• A. Terminate
• B. Confront
• C. Describe the staff nurse's behavior that violated the policy
• D. Determine the employee's awareness of the policy

Correct answer: A

Rationale: When an employee does not respond to disciplinary measures, termination may be necessary. This is a last resort for managers when other strategies to improve performance have failed. Terminating an employee means ending their employment with the organization. Choices B, C, and D are incorrect as the question specifically asks what action the manager must take when an employee does not respond to discipline. Confronting the employee, describing the behavior, or determining awareness of the policy are steps that may precede termination but are not the final action to be taken.

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