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?

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.

Correct Answer: D

Rationale: The correct answer is D because asking construction workers to be responsible for the equipment and sharp items used is not within the charge nurse's role or authority. The responsibility for ensuring safety and security in the Emergency Department lies with the healthcare staff (including the charge nurse) and security personnel. Construction workers may not have the training or expertise to handle agitated patients or prevent potential incidents. A: Notifying the nursing supervisor (A) can help escalate the issue and involve higher authority in addressing the safety concern. B: Notifying security (B) is essential to ensure that trained professionals are present to handle security-related issues. C: Having staff check patients (C) is important to verify their safety, but it does not address the primary concern of preventing patients from accessing construction equipment as weapons.

Correct Answer: A

Rationale: The correct answer is A because it prioritizes client autonomy and respects their wishes. By engaging the client and asking why they want to discuss advance directives without their partner present, the nurse acknowledges the client's right to make decisions about their own healthcare. This approach promotes open communication and allows the client to express their concerns and preferences freely. Choice B is incorrect as it assumes the client only needs information and brochures without addressing their specific needs or concerns. Choice C is incorrect as it delays addressing the client's immediate questions and concerns about advance directives. Choice D is incorrect as it disregards the client's request to discuss advance directives and focuses solely on their current feelings.

Correct Answer: A

Rationale: The correct answer is A: Prepare an agenda. This approach ensures that all relevant points are covered by structuring the meeting topics in a logical sequence. Step 1: Identify key discussion points. Step 2: Organize them in a coherent order on the agenda. Step 3: Share the agenda with participants beforehand. This allows everyone to come prepared, promotes focus, and helps stay on track during the meeting. Visual aids (B) may enhance understanding but don't ensure all points are covered. Inviting only key stakeholders (C) limits perspectives. Reviewing previous budgets (D) is valuable but not sufficient for comprehensive coverage.

Correct Answer: C

Rationale: The correct answer is C: Staffing that minimizes overtime. Politics involves influencing resource allocation, and staffing decisions directly impact the allocation of human resources, a scarce resource in healthcare settings. Minimizing overtime through effective staffing management is crucial for efficient resource utilization. Raises for the staff (A) are more related to compensation rather than resource allocation. Patient supplies (B) and paper for the printer (D) are important resources but not directly tied to influencing resource allocation in the same way as staffing decisions. In summary, the correct answer, C, directly aligns with the definition of politics and resource allocation in a healthcare setting.

Correct Answer: A

Rationale: The correct answer is A because having family members wear a gown and gloves when visiting a client with C. difficile infection helps prevent the spread of the bacteria to others. This infection is highly contagious and can be transmitted through contact with contaminated surfaces or feces. By wearing protective gear, family members can reduce the risk of spreading the infection to themselves or others. Choice B is incorrect because while cleaning contaminated surfaces with a bleach solution is important, it is not directly related to family members' responsibilities. Choice C is incorrect because alcohol-based hand sanitizers are not effective against C. difficile spores, so proper handwashing with soap and water is recommended. Choice D is incorrect because assigning the client to a room with a private bathroom is not directly related to the responsibility of family members visiting the client.

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.

Correct Answer: A

Rationale: Step 1: The Patient Self-Determination Act requires healthcare providers, including nurses, to inform clients of their right to create an advance directive. Step 2: New nurse graduates need to understand this legal requirement to comply with ethical and legal standards. Step 3: By discussing this requirement with new nurse graduates, they will be better equipped to provide information and support to clients regarding advance directives. Step 4: This step is crucial in ensuring that clients' autonomy and right to self-determination are respected. Step 5: Option A is the correct answer as it directly relates to the legal obligation of nurses in discussing advance directives with clients. Summary: Options B, C, and D are incorrect as they do not address the specific legal requirement outlined in the Patient Self-Determination Act for informing clients about their right to create an advance directive.

Correct Answer: B

Rationale: The correct answer is B: To develop staffing policies and procedures. The primary purpose of a nurse staffing committee is to establish guidelines and protocols for nurse staffing levels to ensure safe and effective patient care. By developing staffing policies, the committee can address issues such as nurse-to-patient ratios, shift scheduling, and workload distribution. This helps maintain quality care and prevent burnout among nurses. Incorrect options: A: To oversee patient safety initiatives - While patient safety is a critical aspect of nursing care, the primary focus of the staffing committee is on developing policies related to nurse staffing, not overseeing patient safety initiatives. C: To coordinate patient care - While coordinating patient care is essential, the primary role of the staffing committee is to focus on staffing policies rather than direct patient care coordination. D: To manage nurse recruitment - Nurse recruitment is typically handled by human resources or a recruitment team, not the staffing committee. The staffing committee's main function is to determine appropriate staffing levels and guidelines.