Nursing Elites

1. The nurse manager has two employees with a longstanding conflict that is affecting the group's productivity and cohesiveness. She decides to meet with the employees in private, bring the conflict out into the open, and attempt to resolve it through knowledge and reason. Which conflict management strategy did she employ?

• A. Confrontation
• B. Suppression
• C. Collaboration
• D. Intervention

Correct answer: A

Rationale: The nurse manager employed the conflict management strategy of 'Confrontation.' Confrontation involves bringing the conflict out into the open and attempting to resolve it through knowledge and reason, making it the most effective means of resolving conflict in this scenario. Choice B, 'Suppression,' involves ignoring or avoiding the conflict, which is not what the nurse manager did. Choice C, 'Collaboration,' refers to working together to find a mutually acceptable solution and was not explicitly mentioned in the scenario. Choice D, 'Intervention,' typically involves a third party stepping in to help resolve the conflict, which was not the case here.

2. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

• A. use only the lispro insulin until the symptoms are resolved
• B. limit calorie intake until the glucose is less than 120 mg/dL
• C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
• D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%

Correct answer: C

Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.

3. When should the nurse initiate discharge planning for a client experiencing an exacerbation of heart failure?

• A. During the admission process
• B. As soon as the client's condition is stable
• C. After consulting with the client's family
• D. During the initial team conference

Correct answer: B

Rationale: The correct time for the nurse to initiate discharge planning for a client experiencing an exacerbation of heart failure is as soon as the client's condition is stable. Discharge planning should begin early to ensure a smooth transition and continuity of care. While involving the client's family in the planning process is crucial, the primary focus should be on starting the preparations for discharge once the client's immediate health concerns are addressed and their condition is stable. Waiting for a team conference or after consulting with the family may delay the planning process, which is not ideal in ensuring a timely and effective discharge plan.

4. A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?

• A. Increase in hematocrit
• B. Increase in respiratory rate
• C. Decrease in heart rate
• D. Decrease in capillary refill time

Correct answer: D

Rationale: The correct answer is D: Decrease in capillary refill time. In a client with fluid volume deficit, improving capillary refill time indicates that the perfusion status is improving due to the increase in fluid volume. Choices A, B, and C are incorrect. An increase in hematocrit may indicate hemoconcentration due to fluid loss, an increase in respiratory rate may suggest respiratory distress, and a decrease in heart rate may not be directly related to fluid volume status.

5. Knowing the different modes of communication used by men and women is important for the nurse manager. Which of the following is a difference in communication in unpleasant situations?

• A. Men tend to talk more, and women withdraw.
• B. Men tend to use tag questions.
• C. Women disagree more.
• D. Women talk longer and faster, men disclose more.

Correct answer: A

Rationale: The correct answer is A. In unpleasant situations, men tend to talk more, while women tend to withdraw. Women are more likely to use tag questions and disclose more. Men, on the other hand, tend to talk longer and may be more inclined to disagree. Therefore, option A is the most accurate choice that highlights a difference in communication styles between men and women in unpleasant situations.

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