Nokea
An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to
- A. give a bolus of 50% dextrose.
- B. insert a large-bore IV catheter.
- C. initiate oxygen via nasal cannula.
- D. administer glargine (Lantus) insulin.
Correct Answer: B
Rationale: The correct answer is B: insert a large-bore IV catheter. In HHS, patients are severely dehydrated due to high blood sugar levels. Inserting a large-bore IV catheter allows for rapid rehydration with isotonic fluids. This helps to correct the hyperosmolarity and electrolyte imbalances. Giving dextrose (choice A) would worsen hyperglycemia, initiating oxygen (choice C) is not directly related to managing HHS, and administering long-acting insulin like glargine (choice D) is not the initial priority in managing acute HHS.
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Even though this is not easy, facilitating ____________ is a mandatory skill for all nurse managers and is crucial in the success of the manager.
- A. resistance
- B. change
- C. planning
- D. collection of data
Correct Answer: B
Rationale: The correct answer is B: change. Nurse managers often encounter resistance when implementing changes in healthcare settings. Facilitating change involves effectively managing resistance, promoting buy-in, and ensuring successful implementation. This skill is crucial for nurse managers to drive positive outcomes and improve patient care. Planning (choice C) and collection of data (choice D) are important skills but do not directly address the challenges of managing change. Resistance (choice A) is the opposite of what nurse managers aim to overcome when leading change initiatives.
A typical budget takes time to prepare. What timetable should the nurse manager plan for the budgeting process?
- A. 9-12 months
- B. 3-6 months
- C. 1-2 months
- D. Over two years
Correct Answer: B
Rationale: The correct answer is B (3-6 months) because this timeframe allows for adequate planning, data collection, analysis, and stakeholder input without being too rushed or prolonged. 9-12 months (A) is too long, leading to potential inefficiencies and outdated information. 1-2 months (C) is too short, risking errors and overlooking crucial details. Over two years (D) is excessive and may lead to budgeting based on outdated or irrelevant information. B strikes the right balance for a thorough and efficient budgeting process.
Which of the following is NOT considered a withdrawal behavior?
- A. Turnover
- B. Strategies
- C. Stress
- D. Punctuality
Correct Answer: B
Rationale: The correct answer is B: Strategies. Withdrawal behaviors are actions employees take to mentally or physically disengage from their work or organization. Turnover involves leaving the organization, stress is a psychological response, and punctuality relates to attendance. Strategies, on the other hand, refer to the methods or plans individuals use to achieve goals, which is not directly related to withdrawal behaviors. Thus, it is not considered a withdrawal behavior.
Which of the following is a key component of patient-centered care?
- A. Provider-centered decision making
- B. Timely discharge
- C. Respect for patient preferences
- D. Focusing on clinical outcomes
Correct Answer: C
Rationale: The correct answer is C: Respect for patient preferences. Patient-centered care focuses on involving patients in the decision-making process and respecting their values, preferences, and needs. This approach emphasizes open communication, shared decision-making, and individualized care. Choice A is incorrect because patient-centered care prioritizes patient preferences over provider preferences. Choice B is incorrect as timely discharge is not a key component of patient-centered care. Choice D is incorrect as patient-centered care goes beyond clinical outcomes to consider holistic well-being and patient satisfaction.
The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia)
through a restricted access medication program. What is most important for the nurse to report
immediately to the health care provider?
- A. The patient's blood pressure is 154/92.
- B. The patient has a history of emphysema
- C. The patient's blood glucose is 86 mg/dL.
- D. The patient has chest pressure when walking
Correct Answer: D
Rationale: The correct answer is D: The patient has chest pressure when walking. This symptom could indicate cardiac issues, a known side effect of rosiglitazone. Reporting this immediately is crucial to prevent potential serious complications.
A: The patient's blood pressure is 154/92. While high, it is not an immediate concern unless accompanied by other symptoms.
B: The patient has a history of emphysema. Relevant but not urgent in this scenario.
C: The patient's blood glucose is 86 mg/dL. Within the normal range and not a priority compared to chest pressure.
In summary, choice D is correct as it addresses a potentially severe side effect of the medication that requires immediate attention. Choices A, B, and C are not as urgent or directly related to the medication's side effects.