Nokea
The nurse determines a need for additional instruction when the patient with newly diagnosed
type 1 diabetes says which of the following?
- A. “I can have an occasional alcoholic drink if I include it in my meal plan.”
- B. “I will need a bedtime snack because I take an evening dose of NPH insulin.”
- C. “I can choose any foods, as long as I use enough insulin to cover the calories.”
- D. “I will eat something at meal times to prevent hypoglycemia, even if I am not hungry.”
Correct Answer: C
Rationale: The correct answer is C because stating "I can choose any foods, as long as I use enough insulin to cover the calories" shows a lack of understanding of diabetes management. In type 1 diabetes, it's crucial to follow a balanced diet to regulate blood sugar levels. Choosing any foods without considering their impact on blood sugar control can lead to unstable glucose levels.
Explanation for why the other choices are incorrect:
A: Choosing to have an occasional alcoholic drink if included in the meal plan is acceptable as long as it's done in moderation and accounted for in the overall diabetes management plan.
B: Needing a bedtime snack with NPH insulin is appropriate to prevent hypoglycemia overnight.
D: Eating something at meal times to prevent hypoglycemia, even if not hungry, is a good practice to maintain stable blood sugar levels.
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A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?
- A. Suction the client's airway.
- B. Instruct the client to perform incentive spirometry every hour.
- C. Assist the client to an upright position.
- D. Humidify the client's supplemental oxygen.
Correct Answer: C
Rationale: The correct answer is C: Assist the client to an upright position. This is the priority intervention because placing the client in an upright position helps improve lung expansion and oxygenation by optimizing ventilation-perfusion matching. This position also reduces the risk of aspiration and improves overall respiratory function.
Choice A (Suction the client's airway) is not the first intervention because difficulty breathing in this scenario is more likely due to positioning rather than airway obstruction.
Choice B (Instruct the client to perform incentive spirometry every hour) is not the first intervention as it may not address the immediate issue of breathing difficulty related to supine positioning.
Choice D (Humidify the client's supplemental oxygen) is not the first intervention as lack of humidification is not likely the cause of the client's difficulty breathing in this situation.
When in opposition to an immediate superior, a nurse manager should use which important strategy in a confrontation?
- A. Using 'I' language
- B. Using absolutes
- C. Using 'why' questions
- D. Using negative assertions
Correct Answer: A
Rationale: The correct answer is A: Using 'I' language. This strategy is effective in confrontation as it focuses on expressing one's own thoughts and feelings without blaming the other person. By using "I" language, the nurse manager can communicate assertively and take ownership of their perspective, which can lead to a more constructive dialogue.
Summary:
B: Using absolutes can come across as rigid and may escalate the confrontation.
C: Using 'why' questions can be perceived as accusatory and defensive, potentially leading to further conflict.
D: Using negative assertions can create a hostile environment and hinder effective communication.
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: The correct answer is C: Reducing job stress. This is an absenteeism management strategy because high job stress can lead to increased absenteeism. By reducing stress through various methods such as workload management, providing support, and promoting work-life balance, organizations can effectively reduce absenteeism rates. Holding regular meetings (A) is important for communication but not a direct absenteeism strategy. Limiting career growth opportunities (B) may actually increase absenteeism due to lack of motivation. Neglecting the issue (D) will only worsen absenteeism rates.
A nurse is caring for a client with a diagnosis of terminal cancer. Which of the following statements by the client should indicate to the nurse that the client is ready to hear information regarding palliative care?
- A. "I am ready to learn about chemotherapy to help cure my cancer."
- B. "I just want you to give me something to get this over with soon."
- C. "I want you to tell me about measures available to keep me comfortable."
- D. "I know that many people have recovered fully from cancer, and so will I."
Correct Answer: C
Rationale: The correct answer is C because the client's statement demonstrates a desire for comfort-focused care, which is the essence of palliative care for terminal cancer patients. The client is expressing a clear preference for measures that prioritize comfort and quality of life over aggressive treatment. This indicates readiness to receive information about palliative care.
Choice A is incorrect because the client mentions chemotherapy for a cure, indicating a focus on curative treatment rather than comfort care. Choice B is incorrect as the client seems to be expressing a desire for a quick end to their suffering, which may not align with palliative care goals. Choice D is incorrect because the client is expressing unrealistic optimism about recovery, which may hinder acceptance of palliative care.
The healthcare provider is developing a critical pathway for congestive heart failure (CHF). Which components are essential to include? (Select ONE that does not apply.)
- A. Expected length of stay
- B. Assigned staff healthcare provider
- C. Patient outcomes
- D. Medical diagnosis
Correct Answer: B
Rationale: The correct answer is B because the assigned staff healthcare provider is not an essential component in developing a critical pathway for congestive heart failure (CHF). The rationale is that the focus of a critical pathway is on standardizing the care process to improve outcomes and efficiency. Including specific assigned staff members may not be feasible due to staffing variations and may limit flexibility in care delivery. Expected length of stay (A) helps in planning resources, patient outcomes (C) are crucial for evaluating effectiveness, and medical diagnosis (D) guides treatment protocols. Therefore, choice B is not essential compared to the other components.