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Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?
- A. Measure the ankle-brachial index.
- B. Check for changes in skin pigmentation.
- C. Assess for unilateral or bilateral foot drop.
- D. Ask the patient about symptoms of depression.
Correct Answer: A
Rationale: The correct answer is A, "Measure the ankle-brachial index." This task involves using a blood pressure cuff and Doppler ultrasound to assess blood flow in the lower extremities, which is within the scope of practice for UAPs. It is a non-invasive procedure that does not require specialized training.
Choice B, "Check for changes in skin pigmentation," involves assessing for potential skin changes related to circulation issues, which requires more in-depth knowledge and interpretation than what UAPs are trained for.
Choice C, "Assess for unilateral or bilateral foot drop," involves evaluating muscle strength and nerve function, which requires clinical judgment and knowledge beyond the scope of UAP practice.
Choice D, "Ask the patient about symptoms of depression," involves assessing mental health and requires communication skills and training that UAPs do not typically have.
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When a nurse observes a fellow nurse preparing an incorrect dose of medication, what is the best action to take?
- A. Ignore the error
- B. Administer the medication anyway
- C. Correct the error without informing the nurse
- D. Report the error to the supervisor immediately
Correct Answer: D
Rationale: The correct answer is D: Report the error to the supervisor immediately. This action prioritizes patient safety and prevents harm. It follows ethical guidelines by promoting transparency and accountability. Reporting the error also upholds professional standards and fosters a culture of continuous learning and improvement. Ignoring the error (A) risks patient harm. Administering the medication anyway (B) compromises patient safety. Correcting the error without informing the nurse (C) overlooks the importance of addressing the root cause and preventing future mistakes.
A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to
- A. use only the lispro insulin until the symptoms are resolved
- B. limit calorie intake until the glucose is less than 120 mg/dL
- C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
- D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%
Correct Answer: C
Rationale: The correct answer is C: monitor blood glucose every 4 hours and notify the clinic if it continues to rise. In this scenario, the patient is experiencing an illness (sore throat and runny nose) which can lead to elevated blood glucose levels due to increased stress hormones. It is essential to closely monitor blood glucose levels to prevent hyperglycemia-related complications. The nurse's advice aligns with the goal of closely monitoring the patient's condition and seeking medical attention if blood glucose levels continue to rise.
Choice A is incorrect because using only lispro insulin may not be sufficient to manage the elevated blood glucose levels caused by illness. Choice B is incorrect as limiting calorie intake may not be the appropriate action to take in this situation. Choice D is incorrect because decreasing carbohydrate intake based on glycosylated hemoglobin levels is not an immediate solution to address the current elevated blood glucose levels due to illness.
Which of the following are managerial functions, according to Mintzberg? (EXCEPT)
- A. Leading and linking at the people level
- B. Communicating and controlling at the information level
- C. Deciding pay structures
- D. Doing at the action level
Correct Answer: C
Rationale: The correct answer is C: Deciding pay structures. According to Mintzberg, managerial functions involve planning, organizing, leading, and controlling. Deciding pay structures falls under the domain of human resource management, not traditional managerial functions. A, B, and D align with Mintzberg's managerial functions as they involve aspects of leading, communicating, controlling, and taking actions within an organization.
An environment that rewards good __________ is the goal in a work environment.
- A. Performance
- B. Turnover
- C. Strategies
- D. Stress
Correct Answer: A
Rationale: The correct answer is A: Performance. In a work environment, rewarding good performance encourages employees to excel and achieve organizational goals. Performance-based rewards motivate employees to work efficiently and effectively. Turnover (B) refers to the rate at which employees leave a company, which is not an ideal goal for a work environment. Strategies (C) are plans or approaches used to achieve objectives, but they are not the direct target of rewards. Stress (D) is a negative factor that should be minimized in a work environment, not rewarded.
The staff nurse is caring for the client with total accountability and is in continual communication with the client, the family, the physicians, and other members of the health care team. This type of nursing delivery system is known as:
- A. Total patient care
- B. Qualified nurse case managers
- C. Established critical pathways
- D. Quality management system
Correct Answer: A
Rationale: The correct answer is A: Total patient care. This system involves the nurse having full accountability for the client's care and maintaining constant communication with all involved parties. This ensures comprehensive and individualized care. Choice B, qualified nurse case managers, typically focus on care coordination rather than direct client care. Choice C, established critical pathways, refers to standardized care plans, not individualized care. Choice D, quality management system, involves monitoring and improving care quality, not the direct provision of care.