Nokea
Which of the following are essential components of strategic planning? (Select all that apply.)
- A. Values
- B. Vision & Mission statements
- C. Reengineering
- D. A & B
Correct Answer: D
Rationale: The correct answer is D because values and vision & mission statements are essential components of strategic planning. Values guide decision-making and behavior, ensuring alignment with the organization's principles. Vision & mission statements define the organization's purpose and goals, providing a roadmap for strategic direction. Reengineering, as mentioned in choice C, is a process improvement approach and not an inherent component of strategic planning. Therefore, choice D is the correct answer as it includes the key components necessary for effective strategic planning.
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As a new graduate employed in a high-volume maternity unit that uses differentiated practice as its staffing model, what can the nurse expect?
- A. Evidence-based practice guides risk management principles.
- B. Client teaching is the responsibility of the team leader.
- C. The initial level of practice responsibility will be limited.
- D. Seniority is the main determinant of client assignments.
Correct Answer: C
Rationale: The correct answer is C because in a high-volume maternity unit that uses differentiated practice, new graduates can expect their initial level of practice responsibility to be limited. This is because differentiated practice involves assigning tasks based on the individual nurse's skills and experience level. New graduates are typically assigned less complex tasks initially to ensure patient safety.
Choice A is incorrect because evidence-based practice and risk management principles are not directly related to the staffing model being used.
Choice B is incorrect because client teaching is typically a shared responsibility among all team members, not solely the team leader.
Choice D is incorrect because in differentiated practice, client assignments are based on individual skills and competencies, not seniority.
A registered nurse (RN) who usually uses public transportation has not renewed her driver’s license. During a recent car trip with a friend, she took over driving when her friend became tired. Which of the following is true?
- A. She has acted in a professional manner.
- B. She may lose her RN license for driving without a license.
- C. She should renew her driver’s license as soon as possible.
- D. Under the circumstances, she will not be faulted for driving without a license.
Correct Answer: B
Rationale: The correct answer is B: She may lose her RN license for driving without a license. As a registered nurse, she is held to a high standard of professional conduct. Driving without a valid license is illegal and unethical, potentially endangering herself and others. This behavior could be viewed as a violation of professional ethics, leading to disciplinary action by the licensing board. Choices A, C, and D are incorrect because they do not address the legal and ethical implications of driving without a valid license for a healthcare professional. A nurse should always adhere to legal and ethical standards to maintain the trust and integrity of the profession.
A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?
- A. Infuse 1 liter of normal saline per hour.
- B. Give sodium bicarbonate 50 mEq IV push.
- C. Administer regular insulin 10 U by IV push.
- D. Start a regular insulin infusion at 0.1 units/kg/hr.
Correct Answer: A
Rationale: The correct answer is A because the priority in treating diabetic ketoacidosis is fluid resuscitation to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps to restore intravascular volume and corrects electrolyte abnormalities. Choice B (sodium bicarbonate) is not recommended routinely in DKA treatment as it may worsen metabolic acidosis. Choice C (IV push insulin) can lead to hypoglycemia and should not be the initial intervention. Choice D (insulin infusion) is important but should be started after fluid resuscitation to avoid rapid drops in blood glucose levels.
The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?
- A. Avoid snacking at bedtime.
- B. Increase the rapid-acting insulin dose.
- C. Check the blood glucose during the night.
- D. Administer a larger dose of long-acting insulin.
Correct Answer: C
Rationale: The correct answer is C: Check the blood glucose during the night. The Somogyi effect is rebound hyperglycemia that occurs in response to hypoglycemia during the night. By checking blood glucose levels during the night, the patient can identify if they are experiencing nighttime hypoglycemia leading to rebound hyperglycemia in the morning. This will help determine the need for adjusting insulin doses or carbohydrate intake.
Why the other choices are incorrect:
A: Avoid snacking at bedtime - does not address the underlying issue of nighttime hypoglycemia.
B: Increase the rapid-acting insulin dose - could potentially worsen the Somogyi effect by causing further hypoglycemia.
D: Administer a larger dose of long-acting insulin - also does not address the issue of nighttime hypoglycemia and may lead to further fluctuations in blood glucose levels.
In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?
- A. First
- B. Second
- C. Third
- D. Fourth
Correct Answer: A
Rationale: The correct answer is A, the first step in the grievance process. When a nurse disagrees with a physician's statements, consulting the nurse manager is an initial step to address the issue informally. This step allows for clarification, communication, and resolution at a lower level before escalating to formal grievance procedures. Choices B, C, and D are incorrect because they pertain to subsequent steps in the process after the issue has become more formalized and escalated beyond the initial stage.