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. Which statement to a patient newly diagnosed with type 2 diabetes is correct?

• A. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
• B. Insulin is not used to control blood glucose in patients with type 2 diabetes.
• C. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
• D. Type 2 diabetes is usually diagnosed when the patient is admitted with a hyperglycemic coma.

Correct answer: C

Rationale: Choice C is the correct statement to convey to a patient newly diagnosed with type 2 diabetes. Lifestyle modifications, such as changes in diet and exercise, are essential components of managing type 2 diabetes. These changes can help control blood glucose levels and improve overall health. Options A, B, and D are incorrect statements. While complications of type 2 diabetes can be serious, they are different from those of type 1 diabetes. Some patients with type 2 diabetes may require insulin therapy, but it is not true that insulin is not used at all. Type 2 diabetes is not typically diagnosed during a hyperglycemic coma, as it is usually identified through routine screenings or symptoms unrelated to a coma.

3. Which of the following best describes the concept of shared governance?

• A. Top-down management
• B. Nurse-led committees
• C. Shared decision making
• D. Hierarchical structure

Correct answer: C

Rationale: The correct answer is C: 'Shared decision making.' Shared governance in healthcare involves empowering nurses to participate in decision-making processes that affect their practice. This model fosters collaboration, transparency, and accountability among healthcare providers. Choice A, 'Top-down management,' is incorrect because shared governance promotes a bottom-up approach. Choice B, 'Nurse-led committees,' is partially correct as it is a component of shared governance, but the core concept is broader and encompasses shared decision making beyond committee leadership. Choice D, 'Hierarchical structure,' is incorrect as shared governance aims to flatten hierarchies and distribute decision-making authority among healthcare team members.

4. Which of the following are managerial functions, according to Mintzberg? (EXCEPT)

• A. Leading and linking at the people level
• B. Communicating and controlling at the information level
• C. Deciding pay structures
• D. Doing at the action level

Correct answer: C

Rationale: The correct answer is C. Mintzberg believed that managing involves communicating and controlling at the information level, leading and linking at the people level, and doing at the action level. Choice A is correct as it aligns with Mintzberg's concept of leading and linking at the people level. Choice B is correct as it aligns with Mintzberg's concept of communicating and controlling at the information level. Choice D is correct as it aligns with Mintzberg's concept of doing at the action level. Choice C, deciding pay structures, is not a managerial function according to Mintzberg's model, making it the exception.

5. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation the RN should include in the reminders is to 'Only use approved abbreviations.' Using shortcuts in documentation (choice A) may lead to errors or omissions, affecting the credibility of documentation. Documentation should be objective (choice C) rather than subjective to ensure accuracy and legal credibility. It is essential to document care promptly after providing it (choice D) to maintain the accuracy and completeness of patient records, but using approved abbreviations is a more specific recommendation to enhance legal credibility.

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