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. A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?

• A. Infuse dextrose 50% by slow IV push.
• B. Administer 1 mg glucagon subcutaneously.
• C. Obtain a glucose reading using a finger stick.
• D. Have the patient drink 4 ounces of orange juice.

Correct answer: C

Rationale: The correct action for the nurse to take first when a patient reports feeling lightheaded and sweaty after being weaned off an insulin drip is to obtain a glucose reading using a finger stick. This will provide crucial information on the patient's current blood glucose level, helping the nurse assess if the symptoms are due to hypoglycemia. Based on the glucose reading, appropriate interventions can be initiated, such as administering dextrose, glucagon, or oral sugars like orange juice if hypoglycemia is confirmed. However, verifying the blood glucose level is the initial step to guide subsequent actions and ensure patient safety.

3. The nurse manager needs to buy six new hospital beds for the unit. What type of budget will be used for this expenditure?

• A. Operating budget
• B. Capital budget
• C. Salary budget
• D. Revenue budget

Correct answer: B

Rationale: The correct answer is B: Capital budget. The capital budget is used for expenditures related to physical renovations, new construction, and new equipment, such as hospital beds. Operating budget (choice A) focuses on day-to-day expenses like supplies and staffing. Salary budget (choice C) pertains specifically to personnel compensation. Revenue budget (choice D) deals with projected income and financial goals, not capital expenditures like purchasing new hospital beds.

4. When trying to facilitate change in the staff, it is necessary to build trust and recognize the need for change. This type of action is known as which of the following, according to Lewin's Force-Field Model?

• A. Moving the system to a new level
• B. Unfreezing the system
• C. Refreezing the system
• D. Institutionalization

Correct answer: B

Rationale: The correct answer is 'Unfreezing the system.' In Lewin's Force-Field Model, unfreezing is the stage where the existing equilibrium is disrupted to motivate participants and prepare them for change. Building trust and recognizing the need for change are essential components of this stage. Choice A, 'Moving the system to a new level,' does not specifically address the initial stage of disruption. Choice C, 'Refreezing the system,' comes after change has been implemented, not before. Choice D, 'Institutionalization,' refers to the stage where the change becomes the new norm, which is different from unfreezing.

5. Which of the following best describes the concept of holistic nursing?

• A. An approach that integrates the mind, body, and spirit in patient care
• B. A method that focuses solely on physical health
• C. A practice that considers only the patient's physical condition
• D. A framework for improving hospital administration

Correct answer: A

Rationale: The correct answer is A: 'An approach that integrates the mind, body, and spirit in patient care.' Holistic nursing is a comprehensive approach that considers the whole person, including their physical, emotional, social, and spiritual well-being. Choice B is incorrect because holistic nursing goes beyond just physical health. Choice C is incorrect because holistic nursing considers various aspects of the patient, not just the physical condition. Choice D is incorrect because holistic nursing is focused on patient care and well-being, not hospital administration.

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