Nursing Elites

1. Which of the following is a key principle of team nursing?

• A. Decentralized decision making
• B. Centralized decision making
• C. Individual accountability
• D. Shared responsibility

Correct answer: D

Rationale: The correct answer is D: 'Shared responsibility.' Team nursing emphasizes shared responsibility among team members for patient care. This approach promotes collaboration and coordination among healthcare professionals to deliver comprehensive and holistic care. Choices A and B are incorrect because team nursing typically involves collaborative decision-making rather than centralized or decentralized decision-making. Choice C, 'Individual accountability,' does not align with the collaborative nature of team nursing, where responsibility is shared among team members rather than falling solely on individuals.

2. In determining a way to make shift change more effective for the nurse and the client, a hospital implemented a course of action. After a week of implementation, the decision was deemed inappropriate. What step of Roger's diffusion of innovations is this?

• A. Confirmation
• B. Implementation
• C. Knowledge
• D. Persuasion

Correct answer: A

Rationale: The correct answer is A: Confirmation. In the diffusion of innovations theory by Rogers, the confirmation stage seeks reinforcement of the action taken. In this scenario, after implementing the course of action regarding shift changes, the decision was reviewed and found inappropriate, aligning with the confirmation phase. Choice B, 'Implementation,' refers to putting the plan into action, which had already been done. Choice C, 'Knowledge,' pertains to becoming aware of the innovation, not evaluating its effectiveness. Choice D, 'Persuasion,' involves efforts to influence individuals to adopt the innovation, not verifying its appropriateness.

3. Which of the following best describes the role of an informatics nurse specialist?

• A. Managing electronic health records
• B. Providing technical support
• C. Educating nursing staff
• D. Improving patient care through technology

Correct answer: D

Rationale: An informatics nurse specialist focuses on improving patient care through technology by implementing, optimizing, and leveraging healthcare information systems. While managing electronic health records and providing technical support may be part of their responsibilities, the primary goal is to enhance patient outcomes and healthcare delivery through the strategic use of technology. Educating nursing staff, although important, is typically not the core role of an informatics nurse specialist.

4. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

• A. use only the lispro insulin until the symptoms are resolved
• B. limit calorie intake until the glucose is less than 120 mg/dL
• C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
• D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%

Correct answer: C

Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.

5. If the nurse and nurse manager did not resolve the situation related to the physician's report about the nurse's performance, what is the length of time allowed for the nurse to submit an appeal?

• A. 10 days
• B. 15 days
• C. 20 days
• D. 30 days

Correct answer: A

Rationale: If the informal discussion between the nurse and nurse manager does not resolve the issue regarding the physician's report on the nurse's performance, the nurse can submit a written appeal within 10 days, according to the healthcare facility policy. This 10-day timeframe ensures a prompt resolution of disputes and maintains clear communication channels within the healthcare setting. Choices B, C, and D are incorrect as they exceed the time limit allowed for the nurse to submit an appeal, which is specified to be 10 days.

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