Nursing Elites

1. Which of the following is NOT considered a withdrawal behavior?

• A. Turnover
• B. Strategies
• C. Stress
• D. Punctuality

Correct answer: B

Rationale: The correct answer is B, 'Strategies.' Withdrawal behaviors are actions employees take to mentally escape the work environment. Turnover, stress, and punctuality are examples of withdrawal behaviors. Turnover refers to employees leaving the workplace, stress leads to disengagement, and lack of punctuality can indicate disinterest or withdrawal. 'Strategies' do not fit the definition of withdrawal behaviors, making it the correct answer.

2. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?

• A. Measure the ankle-brachial index.
• B. Check for changes in skin pigmentation.
• C. Assess for unilateral or bilateral foot drop.
• D. Ask the patient about symptoms of depression.

Correct answer: A

Rationale: The correct answer is A: Measure the ankle-brachial index. This task involves using a Doppler ultrasound device to assess blood flow, which can be safely delegated to UAP. Choices B, C, and D require a higher level of assessment and interpretation that should be performed by licensed nursing staff. Checking for changes in skin pigmentation (B) and assessing for foot drop (C) involve more complex assessments that require nursing judgment. Asking about symptoms of depression (D) involves a psychosocial assessment, which should be performed by licensed personnel qualified to address mental health concerns.

3. Which of the following may be considered an absenteeism management strategy?

• A. Holding regular meetings to address absenteeism
• B. Limiting career growth opportunities
• C. Reducing job stress
• D. Neglecting the issue

Correct answer: C

Rationale: Reducing job stress is an effective absenteeism management strategy because it creates a positive work environment, potentially decreasing the number of sick days taken by employees. Holding regular meetings to address absenteeism is not a strategy to reduce absenteeism but may add to the stress levels of employees. Limiting career growth opportunities is not a recommended strategy and can lead to employee dissatisfaction and higher absenteeism rates. Neglecting the issue of absenteeism by ignoring it can exacerbate the problem and create a negative work culture.

4. 1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?

• A. Blood pressure
• B. Serum creatinine
• C. Chest x-ray
• D. Urine for microalbuminuria

Correct answer: C

Rationale: The correct answer is C: Chest x-ray. While monitoring for complications in a patient with type 2 diabetes, annual tests such as blood pressure measurement, serum creatinine levels, and urine for microalbuminuria are essential. These tests help in assessing kidney function, cardiovascular health, and early signs of kidney damage, which are common complications of diabetes. A chest x-ray is not routinely scheduled annually to monitor for complications related to type 2 diabetes, making it the least applicable option.

5. The staff nurse is caring for the client with total accountability and is in continual communication with the client, the family, the physicians, and other members of the health care team. This type of nursing delivery system is known as:

• A. Total patient care
• B. Qualified nurse case managers
• C. Established critical pathways
• D. Quality management system

Correct answer: A

Rationale: The correct answer is A: Total patient care. Total patient care is the original model of nursing care delivery, in which one RN has complete responsibility for all aspects of care for one or more patients. In this system, the nurse is accountable for the client's care and maintains continuous communication with the client, their family, physicians, and other healthcare team members. Choice B, Qualified nurse case managers, refers to nurses who coordinate care but do not provide direct hands-on patient care. Choice C, Established critical pathways, involves predefined care plans for specific conditions but does not imply direct accountability as in total patient care. Choice D, Quality management system, relates to processes to ensure and enhance the quality of care but is not specifically about the direct provision of patient care.

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