Nokea
An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?
- A. Hemoglobin A1C level 6.2%
- B. Blood pressure 146/88 mmHg
- C. Heart rate at rest 58 beats/minute
- D. High-density lipoprotein (HDL) level 65 mg/dL
Correct Answer: B
Rationale: The correct answer is B because a blood pressure of 146/88 mmHg indicates hypertension, which is a common complication of diabetes. High blood pressure can lead to cardiovascular complications and may warrant a change in therapy. A: Hemoglobin A1C level 6.2% is within the target range for diabetes control. C: Resting heart rate of 58 beats/minute is within the normal range for an active individual. D: HDL level of 65 mg/dL is considered high and is actually beneficial for cardiovascular health.
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What is the main focus of the Magnet Recognition Program?
- A. Nurse satisfaction
- B. Patient outcomes
- C. Financial performance
- D. Nursing excellence
Correct Answer: D
Rationale: The correct answer is D: Nursing excellence. The main focus of the Magnet Recognition Program is to recognize healthcare organizations that demonstrate nursing excellence in practice. This includes promoting a positive work environment, professional development, and quality patient care outcomes. Choice A, nurse satisfaction, is important but not the primary focus of the program. Choice B, patient outcomes, is related to nursing excellence but not the main focus of the program. Choice C, financial performance, is not directly related to nursing excellence and is not a focus of the Magnet Recognition Program.
A manager identifies that he is spending more time than desired on completing repetitive paperwork. Which of the following would be appropriate ways to address this issue? (EXCEPT)
- A. Combining data reports to reduce duplication
- B. Delegating staff evaluations to the staff nurse on the unit with the most experience
- C. Assigning the preliminary draft of the schedule to a subcommittee of staff nurses
- D. Saying no to inappropriate paperwork assignments
Correct Answer: B
Rationale: The correct answer is B because delegating staff evaluations to the staff nurse with the most experience is not an appropriate solution to reduce repetitive paperwork for the manager. Delegating evaluations may not necessarily address the issue of spending too much time on paperwork.
A: Combining data reports can help reduce duplication and streamline the paperwork process.
C: Assigning the preliminary draft of the schedule to a subcommittee can distribute the workload and free up time for the manager.
D: Saying no to inappropriate paperwork assignments is a valid approach to manage workload effectively.
In summary, B is the correct answer as it does not directly address the issue of spending excessive time on paperwork compared to the other options provided.
As an RN stands in line for the cafeteria cashier, he overhears the staff in front of him talking about a client the RN took care of earlier in the week. The client’s room number is mentioned along with the diagnosis and prognosis. Which of the following actions should the RN take?
- A. Join in the conversation in case the RN is assigned to care for the client in the future.
- B. Remind the staff members that they are in a public location and sharing this information is a breach of the Health Insurance Portability and Accountability Act (HIPAA).
- C. Correct a statement made by one of the staff members.
- D. Ignore the conversation.
Correct Answer: B
Rationale: The correct answer is B: Remind the staff members that they are in a public location and sharing this information is a breach of the Health Insurance Portability and Accountability Act (HIPAA).
Rationale:
1. HIPAA protects patients' confidentiality and prohibits the disclosure of personal health information without consent.
2. By reminding the staff members of this breach, the RN upholds ethical standards and protects the client's privacy.
3. Joining the conversation (choice A) would further violate the client's confidentiality.
4. Correcting a statement (choice C) may draw more attention to the conversation, potentially worsening the breach.
5. Ignoring the conversation (choice D) would be neglectful of the RN's duty to protect patient information.
After examining her client's abdomen and noting assessment of significant findings, even though the client says it doesn't hurt, the nurse says to a colleague, 'I think something is going on here; I am going to investigate further.' This nurse is using:
- A. Deductive reasoning.
- B. Intuition.
- C. Trial and error.
- D. Modified scientific method.
Correct Answer: B
Rationale: The correct answer is B: Intuition. The nurse is using intuition because she is relying on her gut feeling or instinct based on her assessment findings, even though the client denies pain. Intuition involves making quick decisions or judgments based on past experiences and knowledge without conscious reasoning. In this scenario, the nurse's intuition prompts her to investigate further despite the client's denial of pain, indicating a deeper understanding of the situation beyond the obvious.
Summary of other choices:
A: Deductive reasoning involves drawing specific conclusions based on general principles or premises, which is not evident in this scenario.
C: Trial and error is a problem-solving method that involves repeatedly trying different approaches until the desired outcome is achieved, which is not applicable here.
D: Modified scientific method involves a structured approach of observation, hypothesis, experimentation, and conclusion, which does not align with the nurse's immediate decision based on intuition.
For a 55-year-old female patient with type 2 diabetes and a nursing diagnosis of imbalanced nutrition: more than body requirements, which goal is most important?
- A. The patient will reach a glycosylated hemoglobin level of less than 7%.
- B. The patient will follow a diet and exercise plan that results in weight loss.
- C. The patient will choose a diet that distributes calories throughout the day.
- D. The patient will state the reasons for eliminating simple sugars in the diet.
Correct Answer: A
Rationale: The correct answer is A: The patient will reach a glycosylated hemoglobin level of less than 7%. This goal is most important because it directly addresses the patient's diabetes management by aiming to achieve good glycemic control. Lowering the HbA1c level to less than 7% is a key indicator of reduced risk for diabetes-related complications. Options B, C, and D are not as critical in addressing the specific nursing diagnosis of imbalanced nutrition. Option B focuses on weight loss, which may not necessarily address the underlying issue of imbalanced nutrition. Option C addresses meal distribution but does not directly target improved glycemic control. Option D emphasizes eliminating simple sugars but does not encompass the comprehensive management of diabetes.