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. What is the main concern with collective bargaining?

• A. Create tension among nurses.
• B. Reform health care.
• C. Secure economic security.
• D. Unite the nurses.

Correct answer: A

Rationale: The main concern with collective bargaining is that it can create tension among nurses. The bargaining process may lead to divisions between staff nurses and management, rather than uniting them. This tension can arise from differing priorities, goals, or interests between the two groups, potentially impacting the effectiveness of the bargaining process. Choices B, C, and D are incorrect because the primary focus of the concern is on the potential negative impact on nurse relationships, not on reforming healthcare, ensuring economic security, or uniting nurses.

3. After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?

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

Correct answer: A

Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.

4. One of the most useful tools to determine reasons for turnover is:

• A. Questioning.
• B. Surveys.
• C. Employee forums.
• D. Telephone calls.

Correct answer: B

Rationale: Surveys are one of the most effective tools to determine reasons for turnover because they allow employees to provide feedback anonymously, leading to more truthful responses. While questioning can be part of the process, surveys provide a structured and standardized way to collect data. Employee forums may not always elicit honest responses due to peer pressure or fear of repercussions. Telephone calls may not reach all employees and do not guarantee anonymity, potentially leading to biased or incomplete information.

5. Several factors are considered in the calculation of the amount of FTEs. Which of the following is NOT considered when calculating the FTEs?

• A. Hours of care provided
• B. Ancillary staff
• C. Procedures to be done
• D. Types of patients

Correct answer: A

Rationale: When calculating Full-Time Equivalents (FTEs), factors such as the hours of work for the staff for two weeks, average daily census, and types of patients are considered. However, the hours of care provided are not typically included in the calculation of FTEs. Therefore, the correct answer is A. Choice B, ancillary staff, can impact FTE calculations as they contribute to the overall workload. Choice C, procedures to be done, can also influence FTE calculations, especially if they affect staffing requirements. Choice D, types of patients, play a role in determining the level of care needed and subsequently impact FTE calculations.

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