Nursing Elites

1. The nurse manager compares the actual results of the budget with the projected results of the budget. What budgeting process is this?

• A. Variable budgeting
• B. Controlling
• C. Revenue sharing
• D. Incremental budgeting

Correct answer: B

Rationale: The correct answer is B: Controlling. Controlling involves comparing actual results with the projected results in the budget to assess performance and take corrective actions if necessary. Choice A, Variable budgeting, focuses on adjusting the budget based on activity levels. Choice C, Revenue sharing, refers to distributing a portion of revenue among stakeholders. Choice D, Incremental budgeting, involves making minor adjustments to the existing budget for the next period based on previous budgets.

2. What is the main purpose of a nursing code of ethics?

• A. To protect the rights and dignity of patients
• B. To ensure compliance with healthcare laws
• C. To set standards for clinical practice
• D. To provide a framework for ethical decision-making in nursing practice

Correct answer: D

Rationale: The main purpose of a nursing code of ethics is to provide a framework for ethical decision-making in nursing practice. While choice A is important, the primary focus of a nursing code of ethics is not solely to protect the rights and dignity of patients but to guide nurses in making ethical decisions. Choice B is more related to legal requirements, not the ethical aspects covered by a code of ethics. Choice C, setting standards for clinical practice, is important but distinct from the primary purpose of a code of ethics, which is centered on ethical decision-making.

3. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?

• A. BUN 21 mg/dL (10 to 20 mg/dL)
• B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
• C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
• D. Sodium 132 mEq/L (136 to 145 mEq/L)

Correct answer: B

Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.

4. Horizontal violence may be observed among staff interactions and causes stress among staff. To minimize stress associated with such interactions, nurses can: (Select all that apply.)

• A. Encourage venting as a way to express feelings.
• B. Take control of the situation by being assertive.
• C. Ignore staff who are volatile.
• D. Avoid interactions with angry staff.

Correct answer: B

Rationale: To minimize stress associated with horizontal violence among staff interactions, nurses should take control of the situation by being assertive. Being assertive allows nurses to address the issues causing stress in a constructive and professional manner. Encouraging venting without addressing the underlying problems may not resolve the situation effectively. Ignoring staff who are volatile can escalate the issue further, and avoiding interactions with angry staff does not address the root cause of the problem. Therefore, being assertive and addressing the situation directly is the most effective approach to minimize stress and promote a healthy work environment.

5. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

• A. Avoid snacking at bedtime.
• B. Increase the rapid-acting insulin dose.
• C. Check the blood glucose during the night.
• D. Administer a larger dose of long-acting insulin.

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

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