Nursing Elites

1. Your nurse manager talks with you once per week to determine how you are adjusting to your role as a new nurse. She asks if you feel that you are able to provide good care to your patients, whether you are becoming familiar with the electronic health record, and whether your preceptor is encouraging your independence. This manager is demonstrating:

• A. An intrusive style.
• B. An effort to understand if you are coping with the demands.
• C. An attempt to intimidate.
• D. An authoritarian style.

Correct answer: B

Rationale: The correct answer is B. The nurse manager is showing an effort to understand if you are coping with the demands of your new role as a nurse. This approach demonstrates empathy and concern for your well-being and professional development. Choices A, C, and D are incorrect because there is no indication of intrusion, intimidation, or authoritarian behavior in the manager's actions. Instead, the manager is engaging in supportive and constructive communication to help you adjust and grow in your new position.

2. A nurse is talking with the partner of a client who has dementia. The client's partner expresses frustration about finding time to manage household responsibilities while caring for their partner. The nurse should identify that the partner is experiencing which of the following types of role-performance stress?

• A. Role ambiguity
• B. Role overload
• C. Role conflict
• D. Sick role

Correct answer: C

Rationale: In this scenario, the partner is struggling to balance caring for their loved one with dementia and managing household responsibilities. This situation represents role conflict, where conflicting demands from different roles (caregiver and homemaker) create stress. Role ambiguity (choice A) refers to uncertainty about what is expected in a role, not conflicting demands. Role overload (choice B) occurs when there are too many responsibilities within a single role, not conflicting roles. The sick role (choice D) is a sociological concept related to the rights and responsibilities of individuals who are ill.

3. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
• B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
• C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
• D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

4. The type of theory that discusses how motivation works to direct a person's efforts is:

• A. Reinforcement.
• B. Operant.
• C. Conditioning.
• D. Process.

Correct answer: D

Rationale: The correct answer is D, Process. Process theory focuses on how motivation directs an individual's efforts into performance. Reinforcement theory, on the other hand, views motivation as a form of learning. It involves operant conditioning, where behavior is associated with consequences. Conditioning is a broad term that includes both classical and operant conditioning, but it does not specifically address how motivation directs efforts. Therefore, choices A, B, and C are incorrect in the context of discussing how motivation works to direct a person's efforts.

5. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the planning phase of addressing an ethical dilemma, the goals of treatment are established, decision makers are identified, and all available options are reviewed. The assessment phase involves collecting data and information, the diagnosis phase involves analyzing the information to identify the problem, and the implementation phase involves carrying out the chosen plan of action. Therefore, in this scenario, where decision makers are being identified, the RN is in the planning stage.

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