Nursing Elites

1. Which of the following best describes the way for a follower to 'manage up'?

• A. Provide feedback to the unit manager when requested.
• B. Assist the manager in capitalizing on their strengths and weaknesses.
• C. If a follower works with a manager displaying poor leadership skills, they should transfer to a different unit.
• D. Demonstrate respect and appreciation for the manager, even when conversing with coworkers.

Correct answer: B

Rationale: The best way for a follower to 'manage up' is to assist the manager in capitalizing on their strengths and weaknesses. This approach involves supporting the manager in leveraging their strengths while helping them address and improve upon their weaknesses. Choice A is not specific enough about the context of providing feedback, which may not always be the best way to manage up. Choice C suggests avoiding the situation rather than actively managing it. Choice D, while important, does not directly address the concept of managing up by helping the manager grow and excel.

2. The nurse and an unlicensed nursing assistant are caring for a group of clients. Which nursing intervention should the nurse perform?

• A. Measure the client's output from the indwelling catheter.
• B. Record the client's intake and output on the I & O sheet.
• C. Instruct the client on appropriate fluid restrictions.
• D. Provide water for a client diagnosed with diabetes insipidus.

Correct answer: C

Rationale: Instructing the client on appropriate fluid restrictions is a nursing intervention that requires professional judgment and should be performed by the nurse. In this scenario, the nurse should provide education regarding fluid restrictions based on the client's individual needs. Measuring the client's output from the indwelling catheter (choice A) and recording intake and output (choice B) can be tasks delegated to the unlicensed nursing assistant. Providing water for a client diagnosed with diabetes insipidus (choice D) is not appropriate as these clients often require careful fluid management to prevent complications.

3. The nurse is caring for a client with myxedema coma. Which of the following interventions should the nurse prioritize?

• A. Administer intravenous fluids
• B. Provide a warming blanket
• C. Administer levothyroxine intravenously
• D. Place the client in Trendelenburg position

Correct answer: C

Rationale: In myxedema coma, the priority intervention is to administer levothyroxine intravenously. Myxedema coma is a severe form of hypothyroidism, and intravenous levothyroxine is crucial to rapidly replace deficient thyroid hormones. Administering intravenous fluids (choice A) may be necessary, but levothyroxine takes precedence. Providing a warming blanket (choice B) can help maintain the client's body temperature, but it does not address the underlying thyroid hormone deficiency. Placing the client in Trendelenburg position (choice D) is not indicated and can potentially worsen the client's condition.

4. The client with newly diagnosed type 2 diabetes mellitus is being taught about self-care management. Which of the following statements indicates a need for further teaching?

• A. I will rotate my injection sites to prevent skin damage.
• B. I can stop taking my medication if my blood sugar is normal.
• C. I should monitor my blood sugar levels regularly.
• D. I should follow a healthy diet and exercise regularly.

Correct answer: B

Rationale: The correct answer is B. Clients with type 2 diabetes mellitus should not stop taking their medication even if blood sugar levels are normal. This is because ongoing management is necessary to control blood sugar levels and prevent complications. Choice A is correct as rotating injection sites helps prevent skin damage and improves insulin absorption. Choice C is correct as regular monitoring of blood sugar levels is vital for managing diabetes effectively. Choice D is correct as following a healthy diet and exercising regularly are key components of diabetes management.

5. A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide?

• A. Administer desmopressin while the suspension is cold.
• B. Your condition isn't chronic, so you won't need to wear a medical identification bracelet.
• C. You may not be able to use desmopressin nasally if you have nasal discharge or blockage.
• D. You won't need to monitor your fluid intake and output after you start taking desmopressin.

Correct answer: C

Rationale: The correct instruction is choice C: 'You may not be able to use desmopressin nasally if you have nasal discharge or blockage.' Nasal congestion or blockage can interfere with the absorption of nasally administered desmopressin. Choices A, B, and D are incorrect. Choice A is unnecessary as the temperature of the suspension does not impact desmopressin administration. Choice B is incorrect as wearing a medical identification bracelet is essential for individuals with diabetes insipidus to alert healthcare providers in case of emergencies. Choice D is incorrect as monitoring fluid intake and output is crucial when taking desmopressin to ensure proper hydration and medication effectiveness.

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