A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?
- A. The patient always carries hard candies when engaging in exercise.
- B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
- C. The patient has a peanut butter sandwich before going for a bicycle ride.
- D. The patient increases daily exercise when ketones are present in the urine.
Correct Answer: D
Rationale: The correct answer is D. Increasing exercise when ketones are present can worsen diabetic ketoacidosis. A patient should not exercise with ketones in urine. Carrying candies for exercise (A) helps manage low blood sugar. Going for a walk with a glucose of 200 mg/dL (B) can help lower blood sugar. Eating a sandwich before exercise (C) provides fuel.
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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. In team nursing, all team members share responsibility for patient care, promoting collaboration and teamwork. This principle ensures that each team member contributes to decision-making and patient outcomes.
A: Decentralized decision making is not a key principle of team nursing as it involves individual team members making decisions independently, which can lead to lack of coordination.
B: Centralized decision making is also not a key principle of team nursing as it involves decision-making being controlled by a single authority, undermining the collaborative nature of team nursing.
C: Individual accountability is important in team nursing, but it is not the key principle. Shared responsibility emphasizes collective accountability and collaboration among team members.
A supervisor is restricting the flow of communication between staff. This has resulted in the staff having two very opposite directions. The supervisor's actions are known as which type of force?
- A. Opposing force
- B. Driving force
- C. Restraining force
- D. Restrictive force
Correct Answer: C
Rationale: The correct answer is C: Restraining force. In this scenario, the supervisor's actions of restricting communication act as a restraining force, hindering the flow of information and causing conflicting directions among the staff. A restraining force limits the ability of individuals or groups to achieve their goals by imposing obstacles or constraints. Opposing force (A) implies a force in direct opposition, which is not the case here. Driving force (B) typically motivates action rather than restricts it. Restrictive force (D) is similar to restraining force but lacks the specific connotation of limiting communication in this context.
A registered nurse (RN) administered a patient’s morning insulin as the breakfast tray arrived at 0800. The RN performed a complete assessment at the same time. Then, the RN got busy with her other patients and did not check on the patient until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. Which of the following could the RN be charged with?
- A. Quasi-intentional tort
- B. Misdemeanor
- C. Negligence
- D. Juvenile offense
Correct Answer: C
Rationale: The correct answer is C: Negligence. The RN failed to monitor the patient after administering insulin, leading to a critical situation. Negligence in nursing involves a breach of duty of care that results in harm to the patient. In this case, the RN's failure to check on the patient for several hours directly contributed to the patient becoming unresponsive with dangerously low blood glucose levels. This constitutes a clear case of nursing negligence.
A: Quasi-intentional tort involves intentional actions that result in harm, such as defamation or invasion of privacy. This scenario does not involve intentional harm.
B: Misdemeanor refers to a criminal offense less serious than a felony. Negligence in nursing is typically addressed through civil, not criminal, proceedings.
D: Juvenile offense pertains to actions committed by minors. The RN is a healthcare professional, not a minor, and the offense here is related to professional negligence, not juvenile misconduct.
The staff in the emergency department has presented the nurse leader with a suggestion for streamlining the triage process, cutting down on wait times. Which of the following qualities does the leader specifically need to implement the suggestion?
- A. Courage
- B. Integrity
- C. Energy
- D. Initiative
Correct Answer: D
Rationale: The correct answer is D: Initiative. In this scenario, the nurse leader needs to take the initiative to implement the suggested changes for streamlining the triage process. By showing initiative, the leader demonstrates the willingness to take action and drive the necessary changes forward. Courage (A) may be needed to face challenges, but it doesn't directly address the need for proactive action. Integrity (B) is important but doesn't specifically relate to implementing changes. Energy (C) is beneficial for motivation but doesn't focus on taking the first step to make changes happen. Therefore, the key quality required in this situation is initiative to drive process improvements efficiently.
What is the primary goal of a clinical nurse leader (CNL)?
- A. To manage the nursing staff
- B. To coordinate patient care
- C. To improve patient outcomes
- D. To implement evidence-based practices
Correct Answer: C
Rationale: The primary goal of a clinical nurse leader (CNL) is to improve patient outcomes. CNLs focus on enhancing the quality of care provided to patients by coordinating and overseeing healthcare processes. They work to ensure that patients receive the best possible care and achieve positive health outcomes. Managing nursing staff (A) is not the primary goal of a CNL, as their role is more patient-centered. While coordinating patient care (B) is an important aspect of a CNL's responsibilities, the ultimate goal is to improve patient outcomes. Implementing evidence-based practices (D) is essential for achieving better patient outcomes, but it is not the primary goal of a CNL, as their main focus is on the overall improvement of patient health and well-being.
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