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 a primary responsibility of a nurse case manager?

• A. Direct patient care
• B. Financial planning
• C. Conduct health education
• D. Coordinate patient transitions

Correct answer: D

Rationale: A primary responsibility of a nurse case manager is to coordinate patient transitions. This involves ensuring smooth transitions between healthcare settings, coordinating care plans, and ensuring continuity of care for patients. While direct patient care, financial planning, and health education are important aspects of healthcare, they are not primary responsibilities of a nurse case manager. Nurse case managers focus on managing and coordinating the overall care and services for patients.

3. Which of the following best describes the concept of patient autonomy?

• A. The right of patients to make their own healthcare decisions
• B. The duty to do no harm
• C. The obligation to tell the truth
• D. The responsibility to provide equitable care

Correct answer: A

Rationale: Patient autonomy refers to the right of patients to make their own healthcare decisions based on their values and preferences. It emphasizes the importance of respecting patients' rights to choose their treatment options, even if their decisions may not align with healthcare providers' recommendations. Choice B, the duty to do no harm, refers to the ethical principle of nonmaleficence, which is separate from patient autonomy. Choice C, the obligation to tell the truth, is related to the principle of veracity and does not directly encompass patient autonomy. Choice D, the responsibility to provide equitable care, pertains to the concept of justice in healthcare and is not synonymous with patient autonomy.

4. What are the final stages of the conflict process?

• A. Antecedent conditions
• B. Perceived and felt conflict
• C. Suppression and resolution
• D. Conflict behavior

Correct answer: C

Rationale: The final stages of the conflict process involve suppression and resolution. After conflicts have been perceived and felt, individuals and parties typically move towards suppressing the conflict (trying to avoid it) and ultimately resolving it. Antecedent conditions refer to factors that exist before conflict arises and do not represent the final stages. Conflict behavior relates to the actions taken during a conflict rather than its final stages.

5. Penalties should be __________ .

• A. Determining the employee's awareness of the policy
• B. Describing the staff nurse's behavior that violated the policy
• C. Progressive
• D. Confrontation

Correct answer: C

Rationale: Penalties for policy violations should be progressive. This means that the disciplinary actions should escalate based on the severity or frequency of the violation. For minor infractions, like smoking in an unauthorized area, a progressive approach may include oral warnings, written warnings, suspension, and termination if the behavior persists. In contrast, major violations, such as theft, may warrant immediate and severe consequences like suspension or termination. Choices A, B, and D are incorrect as they do not address the concept of progressively escalating penalties based on the violation's severity or recurrence.

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