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 client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?

• A. Continuous quality improvement
• B. Total quality management
• C. Six Sigma
• D. Quality management

Correct answer: B

Rationale: Total Quality Management (TQM) emphasizes meeting customer needs and satisfaction. In this scenario, by honoring the client's request to delay care to allow for rest, the nurse is aligning with the customer-focused approach of TQM. TQM seeks to continuously improve processes and services to enhance customer experiences and outcomes. Continuous Quality Improvement focuses on incremental improvements in processes and outcomes over time. Six Sigma is a data-driven approach to process improvement that aims to reduce defects and errors. Quality Management is a broader concept that encompasses various strategies to ensure quality standards are met.

3. Which of the following best describes the role of a nurse preceptor?

• A. Supervisor of all nursing staff
• B. Mentor and educator for new nurses
• C. Director of nursing services
• D. Coordinator of patient care

Correct answer: B

Rationale: The correct answer is B: 'Mentor and educator for new nurses.' A nurse preceptor plays a crucial role in mentoring and educating new nurses. They provide guidance, support, and practical knowledge to help new nurses transition smoothly into their roles. While preceptors may have supervisory responsibilities during the orientation period, their primary focus is on supporting the professional development of new nurses, rather than supervising all nursing staff, directing nursing services, or coordinating patient care. Choice A is incorrect because a nurse preceptor does not supervise all nursing staff but focuses on new nurses. Choice C is incorrect as the role of a director of nursing services involves overall management and leadership of nursing services. Choice D is incorrect as a coordinator of patient care is responsible for organizing patient care activities, not specifically focused on mentoring new nurses.

4. What characteristics will you emphasize in a job interview that will positively influence the meeting?

• A. Patient diagnoses that are of greatest interest.
• B. Avoiding challenging patient assignments to minimize the risk of making a mistake.
• C. Number of times you inserted a nasogastric tube.
• D. Your grades on your scholarly papers in nursing school.

Correct answer: D

Rationale: The correct answer is D because emphasizing your grades on scholarly papers in nursing school during a job interview can demonstrate your motivation, interest in achieving, and potential for professional growth and success. This evidence of academic success is often seen as a predictor of how well you may perform in a professional setting. Choices A, B, and C are incorrect. Choice A focuses on patient diagnoses, which may not directly relate to your academic achievements. Choice B suggests avoiding challenging assignments, which does not demonstrate a willingness to learn and grow. Choice C, regarding the number of times you inserted a nasogastric tube, is too specific and does not provide a broad view of your capabilities and potential as a professional.

5. An RN�s current patient and family have presented her with an ethical dilemma. What is the first step the RN should take to find a workable solution to the problem?

• A. Planning
• B. Assessment
• C. Evaluation
• D. Implementation

Correct answer: B

Rationale: The first step is assessment and identification of the problem.

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