Nursing Elites

1. Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)?

• A. Glyburide decreases glucagon secretion from the pancreas.
• B. Glyburide stimulates insulin production and release from the pancreas.
• C. Glyburide should be taken even if the morning blood glucose level is low.
• D. Glyburide should not be used for 48 hours after receiving IV contrast media.

Correct answer: B

Rationale: The correct answer is B: Glyburide stimulates insulin production and release from the pancreas. Glyburide belongs to the sulfonylurea class of antidiabetic medications, which work by stimulating the pancreas to produce and release more insulin. This helps to lower blood glucose levels. Choice A is incorrect because glyburide does not decrease glucagon secretion; instead, it acts on insulin. Choice C is incorrect because taking glyburide when blood glucose is low can lead to hypoglycemia. Choice D is incorrect as there is no specific interaction between glyburide and IV contrast media that requires avoiding its use for 48 hours.

2. From a unit perspective, disruptive and violent patient behavior may be distracting to patients and staff. As the nurse manager, you are concerned about: (EXCEPT)

• A. Patient and staff safety.
• B. Team tension.
• C. Fear of disappointment.
• D. Stress levels.

Correct answer: C

Rationale: Disruptive and violent patient behavior can indeed pose challenges on a unit. Concerns as a nurse manager would revolve around patient and staff safety (Choice A) due to the risk of harm, team tension (Choice B) arising from managing such situations, and stress levels (Choice D) of both patients and staff. Fear of disappointment (Choice C) is not a typical concern in this scenario and does not directly relate to the immediate impact of disruptive and violent patient behavior.

3. During a performance appraisal, how should the manager best provide constructive feedback to an employee?

• A. Focus only on the negative aspects of performance
• B. Provide general comments without specifics
• C. Discuss specific examples of strengths and areas for improvement
• D. Delay feedback until the next appraisal period

Correct answer: C

Rationale: During a performance appraisal, the best approach to provide constructive feedback is by discussing specific examples of strengths and areas for improvement. This method allows the employee to understand what they are excelling at and where they need to focus on development. By highlighting both aspects, the employee can work on enhancing their performance effectively. Option A is incorrect because solely focusing on the negative aspects can demotivate the employee and hinder their growth. Option B is incorrect as providing general comments without specifics does not offer clear guidance for improvement. Option D is also incorrect as delaying feedback can prevent timely corrective actions and hinder performance progress.

4. A nurse is caring for a client after knee replacement surgery. The nurse discovers that the consent was not signed before the surgery. Which of the following charges could be filed?

• A. False imprisonment
• B. Libel
• C. Battery
• D. Malpractice

Correct answer: C

Rationale: The correct answer is C: Battery. Battery occurs when an individual is touched without consent. Performing surgery without a signed consent constitutes battery as it involves touching the patient's body without proper authorization. False imprisonment (choice A) involves restraining someone against their will, which is not applicable in this scenario. Libel (choice B) refers to written defamation, which is not relevant to the situation described. Malpractice (choice D) involves negligence or incompetence in providing professional services, which is different from the lack of consent issue presented in this case.

5. What is the main purpose of a healthcare proxy?

• A. To manage financial affairs
• B. To make medical decisions on behalf of the patient
• C. To provide legal representation
• D. To oversee patient discharge planning

Correct answer: B

Rationale: The main purpose of a healthcare proxy is to make medical decisions on behalf of the patient when they are unable to do so. Choice A is incorrect as managing financial affairs is typically handled by a power of attorney for finances. Choice C is incorrect as a healthcare proxy is not meant to provide legal representation. Choice D is incorrect as overseeing patient discharge planning is a responsibility of healthcare providers, not a healthcare proxy.

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