Nursing Elites

1. The type of theory that discusses how motivation works to direct a person's efforts is:

• A. Reinforcement.
• B. Operant.
• C. Conditioning.
• D. Process.

Correct answer: D

Rationale: The correct answer is D, Process. Process theory focuses on how motivation directs an individual's efforts into performance. Reinforcement theory, on the other hand, views motivation as a form of learning. It involves operant conditioning, where behavior is associated with consequences. Conditioning is a broad term that includes both classical and operant conditioning, but it does not specifically address how motivation directs efforts. Therefore, choices A, B, and C are incorrect in the context of discussing how motivation works to direct a person's efforts.

2. Nonverbal messages in communication, including body language and environmental factors, are called ___________.

• A. lateral communication
• B. upward communication
• C. metacommunications
• D. downward communication

Correct answer: C

Rationale: Nonverbal messages in communication, such as body language and environmental factors, are termed metacommunications. Choice A, lateral communication, refers to communication between individuals or groups on the same hierarchical level. Choice B, upward communication, involves the flow of information from lower levels to higher levels in an organization. Choice D, downward communication, relates to the transmission of information from higher levels to lower levels within an organization. Therefore, the correct term for nonverbal messages in communication is metacommunications.

3. The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose

• A. washes the puncture site using warm water and soap
• B. chooses a puncture site in the center of the finger pad
• C. hangs the arm down for a minute before puncturing the site
• D. says the result of 120 mg indicates good blood sugar control

Correct answer: B

Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad is not recommended for blood glucose monitoring. The recommended sites are the sides of the fingertips. Option A is correct as washing the puncture site using warm water and soap is a good practice. Option C is also correct as hanging the arm down for a minute can help increase blood flow. Option D is incorrect as a blood sugar level of 120 mg/dL may not necessarily indicate good blood sugar control and needs further interpretation.

4. A nurse is admitting a client who has an abdominal wound with a large amount of purulent drainage. Which of the following types of transmission precautions should the nurse initiate?

• A. Droplet precautions
• B. Protective environment
• C. Airborne precautions
• D. Contact precautions

Correct answer: D

Rationale: The correct answer is D: Contact precautions. Contact precautions are used when there is a risk of transmission of infections through direct or indirect contact. In this scenario, the client has an abdominal wound with purulent drainage, indicating a potential for infection transmission through contact. Droplet precautions (choice A) are used for infections transmitted through respiratory droplets, such as influenza. Protective environment (choice B) is used for immunocompromised clients. Airborne precautions (choice C) are used for infections transmitted through small droplets that remain in the air, like tuberculosis. Therefore, in this case, the nurse should initiate contact precautions to prevent the spread of infection.

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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