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. Following a unilateral adrenalectomy, Nurse Betty would assess for hyperkalemia indicated by which of the following signs?

• A. Muscle weakness
• B. Tremors
• C. Diaphoresis
• D. Constipation

Correct answer: A

Rationale: Muscle weakness is a classic manifestation of hyperkalemia, an elevated level of potassium in the blood. After an adrenalectomy, where one adrenal gland is removed, there may be a risk of hyperkalemia due to altered hormone regulation. Tremors (Choice B) are not typically associated with hyperkalemia but may be seen in conditions like hypocalcemia. Diaphoresis (Choice C) and constipation (Choice D) are not specific indicators of hyperkalemia. Diaphoresis is excessive sweating and constipation is a common gastrointestinal issue, neither directly related to potassium imbalances.

3. A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client's anxiety would be to:

• A. Administer a sedative
• B. Make sure the client knows all the correct medical terms to understand what is happening.
• C. Ignore the signs and symptoms of anxiety so that they will soon disappear.
• D. Convey empathy, trust, and respect toward the client.

Correct answer: D

Rationale: Conveying empathy, trust, and respect can help reduce the client's anxiety and improve their overall experience during treatment. This approach creates a supportive environment and fosters a sense of safety and understanding for the client. Administering a sedative (Choice A) should not be the initial intervention for anxiety, as it does not address the underlying emotional needs of the client. Making sure the client knows all the correct medical terms (Choice B) may increase anxiety by overwhelming the client with technical information. Ignoring signs and symptoms of anxiety (Choice C) can lead to worsening distress and potential complications in the client's care.

4. A psychological contract exists between staff members and nurse managers. Which of the following best describes this relationship?

• A. Nurse managers provide positive evaluations, and in turn, staff members do what managers ask of them.
• B. Nurse managers coordinate multiple departments and supervise multiple staff members.
• C. Staff members do what managers ask of them and, in turn, are rewarded through assignments, promotions, and evaluations.
• D. Nurse managers advocate for staff and support nursing roles and ethical practice.

Correct answer: C

Rationale: The correct answer is C. In a psychological contract between staff members and nurse managers, staff members are expected to fulfill the requests of managers, and in return, they are rewarded with assignments, promotions, and evaluations. This reciprocal relationship forms the basis of the psychological contract. Choices A, B, and D are incorrect because they do not accurately capture the essence of the psychological contract. While nurse managers may provide positive evaluations, coordinate departments, supervise staff, advocate for staff, and support nursing roles, these actions alone do not define the specific reciprocal nature of the psychological contract outlined in choice C.

5. A client with diabetes mellitus is scheduled for surgery. The nurse should prioritize which of the following preoperative actions?

• A. Administer a full dose of insulin before surgery
• B. Hold all oral hypoglycemic agents the day before surgery
• C. Monitor blood glucose levels closely before surgery
• D. Instruct the client to avoid all fluids the morning of surgery

Correct answer: C

Rationale: Monitoring blood glucose levels closely before surgery is the priority for a client with diabetes mellitus. This allows for early detection of any abnormalities and helps prevent hypo- or hyperglycemia complications that can arise during the perioperative period. Option A is incorrect because insulin dosing should be individualized based on the client's current blood glucose levels and the surgical plan. Option B is incorrect as abruptly holding oral hypoglycemic agents can lead to uncontrolled blood glucose levels. Option D is incorrect as adequate fluid intake is important for the client's hydration status and overall well-being before surgery.

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