The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?

Correct Answer: B

Rationale: The correct answer is B: Schedule the patient for a fasting blood glucose level. At the first prenatal visit, it is important to assess the patient's risk factors for developing gestational diabetes, especially with a family history of diabetes. A fasting blood glucose level will provide an initial screening to determine if the patient is at risk for gestational diabetes. This test is non-invasive, cost-effective, and provides valuable information early in the pregnancy. Teaching about administering regular insulin (A) is premature without confirming a diagnosis. An oral glucose tolerance test at the twenty-fourth week (C) is typically done later in pregnancy to diagnose gestational diabetes. Providing teaching about fetal problems with gestational diabetes (D) is important but should come after confirming the diagnosis.

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.

Correct Answer: C

Rationale: The correct answer is C. The unit director should follow the institution's formal process for reporting and handling practices that jeopardize patient safety when dealing with an incompetent employee. 1. Firstly, it is important to prioritize patient safety above all else. 2. By following the institution's formal process, the director ensures that the proper steps are taken to address the incompetence effectively. 3. This approach also promotes transparency and accountability within the organization. 4. It aligns with ethical principles of duty to care and responsibility for patient well-being. The other choices are incorrect: A: Tolerating incompetence is not an acceptable approach as it can compromise patient safety. B: Incompetence can have broader impacts beyond the individual nurse, such as affecting patient outcomes and overall team performance. D: While nurse practice acts may provide guidance, the institution's specific procedures should be followed to address incompetence effectively.

Correct Answer: C

Rationale: The correct answer is C because many nurses felt frustrated with the lack of independent functioning after the Vietnam War. This is a significant challenge as nurses were accustomed to a high level of autonomy in field hospitals during wartime but faced restrictions in civilian healthcare settings. This led to dissatisfaction and a sense of limitation in their professional roles. Explanation of why other choices are incorrect: A: Nursing contributing to the stigma of AIDS in the 1980s out of fear is not a challenge that the profession faced but rather a societal issue related to lack of knowledge and fear of the disease. B: Nursing practice flourishing in field hospitals during the Korean War with abundant supplies and equipment is not a challenge but a positive aspect of nursing history. D: A decline in the number of hospice nurses due to ethical dilemmas is a specific problem related to hospice care and not a widespread challenge faced by the entire profession of nursing.

Correct Answer: D

Rationale: The correct answer is D because it shows the client is willing to involve their partner in the learning process, indicating readiness for education. Involving a partner can enhance support and understanding, leading to better adherence. A: Time preference does not directly relate to readiness to learn about insulin. B: Difficulty reading instructions due to glasses is a practical issue, not an indicator of readiness. C: Expressing doubt or questioning the necessity of learning indicates potential resistance or lack of motivation.

Correct Answer: C

Rationale: The correct answer is C because shared governance involves staff nurses and CNAs collaborating in decision-making processes, such as creating schedules. This promotes autonomy, teamwork, and mutual respect. Option A involves delegation, not shared decision-making. Option B shows centralized authority by nurse managers. Option D indicates hierarchical decision-making, not shared governance. In summary, choice C aligns with the principles of shared governance, while the other options do not involve the active involvement of both staff nurses and CNAs in decision-making.

Correct Answer: D

Rationale: The correct answer is D because ethical principles can indeed serve as the foundation for laws. Laws often reflect societal ethical values and principles. Ethical principles provide a moral framework that lawmakers may use to create laws that promote justice and fairness. By basing laws on ethical principles, societies aim to uphold shared values and promote good conduct. In contrast, A is incorrect as the government enforces laws, not ethics. B is incorrect because laws are legal rules, not ethical principles. C is incorrect as ethics are principles of right and wrong, not necessarily highly detailed.

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.

Correct Answer: A

Rationale: The correct answer is A: Expertise. Professionalism is often associated with possessing a high level of expertise or specialized knowledge in a particular field. This expertise allows professionals to perform their duties effectively and competently. Early definitions of professionalism emphasized the importance of possessing the necessary skills and knowledge to excel in one's profession. Choices B, C, and D are incorrect because while empathy, ethical and moral values, and honesty are important characteristics of professionalism, they are not the defining factors. Empathy, ethics, and honesty are crucial components of professional behavior, but without expertise, a professional may not be able to effectively fulfill their responsibilities in their chosen field.