Nokea
A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to
- A. check glucose levels before, during, and after swimming.
- B. delay eating the noon meal until after swimming.
- C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
- D. time the morning insulin injection so that the peak occurs while swimming.
Correct Answer: A
Rationale: The correct answer is A because the patient with type 1 diabetes should check glucose levels before, during, and after swimming to monitor for fluctuations and adjust insulin or food intake accordingly. This allows for better glycemic control and prevents hypoglycemia or hyperglycemia during and after swimming.
Choice B is incorrect because delaying eating can lead to hypoglycemia during swimming due to increased insulin action without adequate glucose intake. Choice C is incorrect as increasing NPH insulin dose without monitoring glucose levels can result in hypoglycemia during exercise. Choice D is incorrect because timing the insulin injection for peak action while swimming can also lead to hypoglycemia if glucose levels are not monitored.
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When seeking their first nursing job, what is the most important factor that nursing graduates look for?
- A. Location
- B. Money
- C. Orientation
- D. Vacation
Correct Answer: C
Rationale: The correct answer is C: Orientation. Nursing graduates prioritize orientation as the most important factor when seeking their first job because it sets the foundation for their transition into the role. A thorough orientation program provides essential training, support, and guidance, which are crucial for their success and confidence in their new position. Location (A) may be important for convenience, but orientation directly impacts their ability to perform their duties effectively. Money (B) and vacation (D) are important but typically take a back seat to factors that directly impact their ability to excel in their new role.
After working at your job for 10 months and feeling unable to tolerate the tension and stress between staff nurses and the laissez-faire nurse manager who is not a leader, what is the best course of action?
- A. Submit a resignation and leave within 30 days.
- B. Complain to staff about the nurse manager.
- C. Seek another position within the healthcare organization and apply for a transfer.
- D. Inform the chief nursing officer that you are leaving and explain your dissatisfaction with the lack of leadership.
Correct Answer: C
Rationale: The correct answer is C because seeking another position within the healthcare organization and applying for a transfer allows you to address the issue of tension and stress while staying within the organization. This option demonstrates a proactive approach to resolving the conflict and shows a commitment to finding a solution rather than just quitting. By transferring to a different position, you can potentially avoid the negative environment while still utilizing your skills and experience within the organization.
Choices A, B, and D are incorrect because they do not address the underlying issue effectively. Option A of submitting a resignation and leaving within 30 days is a hasty decision without exploring potential solutions within the organization. Option B of complaining to staff about the nurse manager may create more conflict and worsen the situation. Option D of informing the chief nursing officer about leaving does not provide a constructive solution to the tension and stress between staff nurses and the nurse manager.
A nurse manager is interested in solving a serious conflict that exists among the nursing staff. He uses a strategy that involves allowing the group to explore a number of solutions and come to a consensus on a solution. What strategy for conflict resolution has the manager used?
- A. Integrative decision-making
- B. Win-win
- C. Competing
- D. Confrontation
Correct Answer: A
Rationale: The correct answer is A: Integrative decision-making. This strategy involves allowing the group to explore multiple solutions and reach a consensus, fostering collaboration and mutual benefit. This approach promotes a win-win outcome and encourages open communication and respect among team members. It is effective for resolving conflicts as it focuses on finding a solution that satisfies the interests of all parties involved.
Choice B: Win-win is a similar concept to integrative decision-making but lacks the emphasis on exploring multiple solutions and reaching a consensus.
Choice C: Competing involves one party winning at the expense of the other, contrary to the collaborative nature of integrative decision-making.
Choice D: Confrontation is a direct and aggressive approach that does not promote collaboration or consensus-building like integrative decision-making does.
A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the
patient has been away from the nursing unit for 2 hours, missing the lunch delivery while
awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to
- A. save the lunch tray for the patient’s later return to the unit
- B. ask that diagnostic testing area staff to start a 5% dextrose IV
- C. send a glass of milk or orange juice to the patient in the diagnostic testing area
- D. request that if testing is further delayed, the patient be returned to the unit to eat.
Correct Answer: D
Rationale: The correct answer is D. It is essential to maintain the patient's blood glucose levels to prevent hypoglycemia. Since the patient missed lunch, returning them to the unit to eat ensures timely access to food for glycemic control. This action addresses the immediate need for nutrition and glucose intake.
A: Saving the lunch tray is not immediate and does not address the patient's current hypoglycemia risk.
B: Starting a dextrose IV is an option for severe hypoglycemia, not for preventing it in this scenario.
C: Sending milk or orange juice may help raise blood sugar but does not address the need for a complete meal to prevent hypoglycemia.
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. Negligence involves a breach of duty of care that results in harm or injury to another person. In this scenario, the RN failed to check on the patient for several hours despite administering insulin and knowing the patient's condition. This failure to provide proper monitoring and care directly led to the patient becoming unresponsive with critically low blood glucose levels.
Choice A, quasi-intentional tort, involves intentional actions that result in harm, which is not applicable in this scenario. Choice B, misdemeanor, refers to a criminal offense of a lesser degree, not a charge that would typically apply to this situation. Choice D, juvenile offense, is not relevant as the RN's actions are not related to the age of the individual involved.