Nursing Elites

1. Which of the following is a common characteristic of a high-performing healthcare team?

• A. Effective communication
• B. Shared leadership
• C. Collaborative decision making
• D. Hierarchical structure

Correct answer: C

Rationale: Collaborative decision making is a key characteristic of a high-performing healthcare team because it involves team members working together to make decisions that lead to the best outcomes for patients. Effective communication is important in any team, but collaborative decision making goes beyond communication by involving team members in the decision-making process. Shared leadership is also crucial for a high-performing team, as it promotes equality and empowerment among team members. On the other hand, a hierarchical structure can hinder effective communication and teamwork by creating barriers between team members and limiting input from all team members, which is counterproductive to achieving optimal healthcare outcomes.

2. Construction is occurring in the Emergency Department, with equipment and sharp items being used by the contractors. As the charge nurse, you are concerned that agitated patients might use the equipment as weapons and you meet with staff to: (EXCEPT)

• A. Notify the nursing supervisor.
• B. Notify security.
• C. Have them check patients to verify safety.
• D. Ask construction workers to be responsible.

Correct answer: D

Rationale: When construction is ongoing in a healthcare setting, it is essential to address safety concerns promptly. While it is crucial to notify the nursing supervisor and security to manage potential risks, having staff check patients for safety is also a valid precautionary measure. However, asking construction workers to be responsible is not a proper action to address the safety concerns posed by the equipment. Construction workers are professionals responsible for their tasks; it is the healthcare facility's responsibility to ensure patient and staff safety in such situations.

3. A nurse recognizes which of the following as a primary goal of nursing?

• A. Assist patients to achieve a peaceful death.
• B. Improve personal knowledge and skills to enhance patient outcomes.
• C. Advocate for quality of life rather than quantity of life.
• D. Work to control costs to enhance patients' quality of life.

Correct answer: A

Rationale: The primary goal of nursing is to promote health, prevent illness, alleviate suffering, and care for the sick. Assisting patients to achieve a peaceful death is an essential aspect of nursing care, ensuring dignity and comfort in the end-of-life phase. While improving personal knowledge and advocating for quality of life are important aspects of nursing, the primary goal remains the well-being and comfort of patients, even in death. Working to control costs, while a consideration in healthcare, is not the primary goal of nursing, which is centered on patient care and well-being.

4. After receiving change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who has a hemoglobin A1C of 12%
• B. 23-year-old with type 1 diabetes who has a blood glucose of 40 mg/dL
• C. 40-year-old who is pregnant and has an oral glucose tolerance test result of 202 mg/dL
• D. 50-year-old who uses exenatide (Byetta) and is complaining of acute abdominal pain

Correct answer: B

Rationale: The correct answer is B because the patient with a blood glucose level of 40 mg/dL (hypoglycemia) needs immediate attention. Hypoglycemia is an emergency situation that requires prompt intervention to prevent adverse effects such as seizures or loss of consciousness. Assessing and managing this patient first is crucial to prevent further deterioration. Choices A, C, and D do not present immediate life-threatening situations requiring urgent intervention like severe hypoglycemia does. While a high hemoglobin A1C level (choice A), an abnormal oral glucose tolerance test result (choice C), and acute abdominal pain (choice D) are important issues, they do not pose an immediate threat to the patient's life compared to severe hypoglycemia.

5. Verbal interventions with an agitated patient may be calming. These interventions include:

• A. Holding and reassuring the patient
• B. Encouraging other staff to distract the patient
• C. Remaining calm and keeping an arm's distance
• D. Standing close to the patient while talking

Correct answer: C

Rationale: The correct answer is C: Remaining calm and keeping an arm's distance. Agitated individuals benefit from minimal verbal and physical stimulation. They respond to their environment based on how nurses interact with them. If an individual feels threatened or cornered, the response will generally be self-protective and reactive. Standing close to the patient (choice D) can be perceived as invasive and may escalate the situation. Holding and reassuring the patient (choice A) may not be effective if the patient perceives it as intrusive. Encouraging other staff to distract the patient (choice B) may introduce unnecessary stimulation. Therefore, the recommended approach is to remain calm and keep a safe distance to provide a non-threatening environment for the agitated patient.

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