Nursing Elites

1. Which of the following is a trait that was found to be common among leaders in trait theory?

• A. Communication of duties assigned
• B. Adaptability and changing priorities
• C. Order giving and decision making for a group
• D. Communication of goal direction

Correct answer: D

Rationale: The correct answer is D, 'Communication of goal direction.' Trait theory suggests that effective leaders possess certain traits, one of which is the ability to clearly communicate the direction and goals of the group. This trait helps in aligning the efforts of the team towards a common objective. Choices A, B, and C are incorrect because while communication, adaptability, decision-making, and order giving are important skills for leaders, the specific trait commonly associated with leaders in trait theory is the ability to communicate the direction and goals.

2. A 27-year-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium level of 3.1 mEq/L. Which action prescribed by the healthcare provider should the nurse take first?

• A. Place the patient on a cardiac monitor
• B. Administer IV potassium supplements
• C. Obtain urine glucose and ketone levels
• D. Start an insulin infusion at 0.1 units/kg/hr

Correct answer: A

Rationale: In a patient with diabetic ketoacidosis (DKA), the initial priority is to assess for any cardiac arrhythmias due to electrolyte imbalances. Since the patient has a low serum potassium level of 3.1 mEq/L, placing the patient on a cardiac monitor is crucial to monitor for any potential cardiac complications. Administering IV potassium supplements (Choice B) may be needed, but it is not the first action to take. Obtaining urine glucose and ketone levels (Choice C) and starting an insulin infusion (Choice D) are important interventions in managing DKA, but ensuring patient safety by monitoring for arrhythmias takes precedence.

3. What is the primary objective of healthcare accreditation programs?

• A. To increase financial profitability
• B. To ensure patient safety and quality care
• C. To streamline healthcare operations
• D. To reduce hospital readmissions

Correct answer: B

Rationale: The primary objective of healthcare accreditation programs is to ensure patient safety and quality care by meeting established standards. Choice A is incorrect because while financial aspects may be indirectly impacted, the main focus is on patient care. Choice C is incorrect as the primary goal is not operational efficiency but rather quality of care. Choice D is incorrect as reducing hospital readmissions is a specific goal that may be influenced by accreditation but not the primary objective.

4. Within the fast-paced, changing healthcare environment, job satisfaction will influence your success. What other characteristic is an asset?

• A. Being friendly
• B. Humility
• C. Ability to anticipate consequences
• D. Flexibility

Correct answer: D

Rationale: In the fast-paced and evolving healthcare setting, flexibility is a crucial asset. Shaffer (2006) emphasizes the importance of being adaptable to change for professional growth. While being friendly and having humility are positive traits, they may not directly address the need to adapt to the dynamic healthcare environment. Anticipating consequences is valuable but may not encompass the breadth of skills needed to navigate rapid changes effectively.

5. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

• A. Lispro (Humalog)
• B. Glargine (Lantus)
• C. Detemir (Levemir)
• D. NPH (Humulin N)

Correct answer: A

Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

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