Nursing Elites

1. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
• B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
• C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
• D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

2. A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?

• A. Satisficing
• B. Routine
• C. Adaptive
• D. Rationalizing

Correct answer: A

Rationale: The correct answer is A: Satisficing. Satisficing is a decision-making strategy where the person chooses an alternative that is good enough given the circumstances. In this scenario, the nurse manager is making a satisfactory decision by managing the unit with the three remaining nurses to meet minimal staffing standards despite the reduced availability of staff. Choice B, Routine, does not apply as the decision made in the scenario is not part of a regular or standard procedure. Choice C, Adaptive, is not the best fit as the decision is more about making do with the available resources rather than adapting to a new situation. Choice D, Rationalizing, does not align with the scenario as it refers to justifying decisions rather than making a practical choice under constraints.

3. The problem of overrating staff performance is called ___________ .

• A. Recency error
• B. Absolute judgment
• C. Halo error
• D. Leniency error

Correct answer: D

Rationale: The correct answer is D, 'Leniency error.' Leniency error occurs when a manager tends to overrate staff performance, giving higher ratings than deserved. Choice A, 'Recency error,' refers to the tendency to focus only on recent behaviors or events when evaluating performance. Choice B, 'Absolute judgment,' is not directly related to overrating staff performance; it refers to making evaluations without considering the context or comparison points. Choice C, 'Halo error,' involves allowing one positive aspect of an individual to overshadow other factors in performance evaluation, which is different from overrating overall staff performance.

4. Which of the following best describes the role of a nurse navigator?

• A. Provide direct patient care
• B. Coordinate complex care
• C. Assist with administrative tasks
• D. Manage clinical trials

Correct answer: B

Rationale: A nurse navigator's primary role is to coordinate complex care for patients, guiding them through the healthcare system. Choice A is incorrect because nurse navigators do not provide direct patient care like nurses in clinical settings. Choice C is incorrect as nurse navigators focus on patient care coordination rather than administrative tasks. Choice D is incorrect as managing clinical trials is typically not within the scope of a nurse navigator's responsibilities.

5. A nurse is considering employment at a long-term care facility that has a functional nursing delivery system. Knowing this, the nurse could expect that:

• A. Each RN would coordinate care for a group of clients.
• B. One RN would pass meds for all clients on a unit.
• C. Each RN would deliver total care to an assigned group of clients.
• D. One RN, one LPN, and one unlicensed assistive personnel would share responsibility for a group of clients.

Correct answer: B

Rationale: In a functional nursing delivery system, tasks are divided among the staff based on their roles. One of these roles is medication administration, where one RN may pass medications for all clients on a unit. Option A is incorrect because coordinating care for a group of clients is more aligned with team nursing. Option C is incorrect as it describes total care nursing, not functional nursing. Option D is incorrect as it reflects team nursing with a mix of different roles sharing responsibility.

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