Nursing Elites

1. Which of the following best describes the role of a nurse case manager?

• A. To provide direct patient care
• B. To manage healthcare facilities
• C. To advocate for patient rights
• D. To coordinate long-term care services

Correct answer: D

Rationale: The correct answer is D: 'To coordinate long-term care services.' A nurse case manager's primary role is to coordinate and manage long-term care services for patients, ensuring continuity and quality of care. Choice A is incorrect because providing direct patient care is typically the responsibility of nurses, not nurse case managers. Choice B is incorrect as managing healthcare facilities is a role usually fulfilled by healthcare administrators. Choice C is incorrect as advocating for patient rights is important but not the primary role of a nurse case manager.

2. Penalties should be __________ .

• A. Determining the employee's awareness of the policy
• B. Describing the staff nurse's behavior that violated the policy
• C. Progressive
• D. Confrontation

Correct answer: C

Rationale: Penalties for policy violations should be progressive. This means that the disciplinary actions should escalate based on the severity or frequency of the violation. For minor infractions, like smoking in an unauthorized area, a progressive approach may include oral warnings, written warnings, suspension, and termination if the behavior persists. In contrast, major violations, such as theft, may warrant immediate and severe consequences like suspension or termination. Choices A, B, and D are incorrect as they do not address the concept of progressively escalating penalties based on the violation's severity or recurrence.

3. When is the first opportunity for a manager to reduce turnover?

• A. When the decision to hire a new employee is made
• B. After one month of employment
• C. After three months of employment
• D. After a certain tenure period

Correct answer: C

Rationale: The manager's first opportunity to reduce turnover occurs after three months of employment. During this period, the manager can assess the employee's performance, engagement, and fit within the organization. It allows the manager to address any concerns, provide support, and intervene early to prevent turnover. Waiting until after a certain tenure period might be too late to effectively mitigate turnover risk, as issues could have already escalated. Therefore, the three-month mark is a critical point for managers to proactively manage turnover. Choices A and B are incorrect because they do not allow sufficient time for the manager to evaluate the employee and take proactive measures to reduce turnover. Choice D is incorrect as it is too vague and does not provide a specific actionable timeframe for addressing turnover concerns.

4. Which of the following actions best demonstrates effective delegation by a nurse manager?

• A. Retaining all tasks
• B. Assigning tasks without supervision
• C. Delegating tasks and providing oversight
• D. Avoiding delegation

Correct answer: C

Rationale: The correct answer is C: Delegating tasks and providing oversight. Effective delegation by a nurse manager involves appropriately assigning tasks to others while also ensuring proper supervision and follow-up. This allows the nurse manager to distribute workload efficiently while maintaining accountability and quality of care. Choices A and D are incorrect as retaining all tasks or avoiding delegation can lead to burnout, inefficiency, and lack of skill development among team members. Choice B is incorrect as assigning tasks without supervision may result in errors, lack of clarity, and potential patient safety issues.

5. A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to

• A. check glucose levels before, during, and after swimming.
• B. delay eating the noon meal until after swimming.
• C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
• D. time the morning insulin injection so that the peak occurs while swimming.

Correct answer: A

Rationale: The correct answer is to teach the patient to check glucose levels before, during, and after swimming. This is important to monitor blood sugar levels and make adjustments as needed to prevent hypoglycemia or hyperglycemia. Delaying eating the noon meal until after swimming (Choice B) is not advisable as the patient needs proper nutrition both before and after exercise. Increasing the morning dose of NPH insulin (Choice C) should not be done without proper medical advice as it can lead to hypoglycemia. Timing the morning insulin injection to coincide with swimming (Choice D) is risky as the peak effect of insulin may lead to hypoglycemia during swimming.

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