Nursing Elites

1. What is the difference between the amounts that were budgeted for specific revenue or cost and the actual revenue or cost that resulted during the course of activities?

• A. Budget
• B. Variable
• C. Variance
• D. Premiums

Correct answer: C

Rationale: The correct answer is C, Variance. Variance represents the distinction between the planned budgeted amount for a particular revenue or cost and the actual amount that occurred during the activities. In financial management, variance analysis is crucial for assessing performance and identifying areas that deviate from the budgeted expectations. Choice A, 'Budget,' is incorrect as it refers to the planned amount rather than the difference between planned and actual amounts. Choice B, 'Variable,' does not specifically address the comparison between budgeted and actual figures. Choice D, 'Premiums,' is unrelated to the concept of comparing budgeted and actual values in the context of financial analysis.

2. A manager is prioritizing the following issues. Of the following issues, which should be considered urgent and important?

• A. The manager of physical therapy calls and complains about inappropriate behaviors of one of the staff nurses with one of his therapists.
• B. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during her current shift, resulting in overdosing of medications.
• C. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick.
• D. A small group of staff nurses request a meeting to discuss initiating a scheduling committee.

Correct answer: B

Rationale: The correct answer is B because patient safety is a critical concern in healthcare settings. Malfunctioning IV pumps leading to medication overdosing poses a direct threat to patient safety and must be addressed urgently. Choice A involves interpersonal issues between staff members which are important but can be addressed in a less urgent manner compared to patient safety concerns. Choice C, a staff nurse calling in sick, is important for staffing but can be managed through existing protocols. Choice D, initiating a scheduling committee, is a routine operational matter that can be addressed at a later time and does not pose an immediate risk to patient safety.

3. A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to

• A. check glucose levels before, during, and after swimming.
• B. delay eating the noon meal until after swimming.
• C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
• D. time the morning insulin injection so that the peak occurs while swimming.

Correct answer: A

Rationale: The correct answer is to teach the patient to check glucose levels before, during, and after swimming. This is important to monitor blood sugar levels and make adjustments as needed to prevent hypoglycemia or hyperglycemia. Delaying eating the noon meal until after swimming (Choice B) is not advisable as the patient needs proper nutrition both before and after exercise. Increasing the morning dose of NPH insulin (Choice C) should not be done without proper medical advice as it can lead to hypoglycemia. Timing the morning insulin injection to coincide with swimming (Choice D) is risky as the peak effect of insulin may lead to hypoglycemia during swimming.

4. A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?

• A. Satisficing
• B. Routine
• C. Adaptive
• D. Rationalizing

Correct answer: A

Rationale: Satisficing is the correct decision-making strategy in this scenario. The nurse manager is not aiming for the best solution but rather choosing an alternative that is good enough given the circumstances of staff shortage. Choice B, Routine, does not apply here as the situation is not part of the manager's regular tasks. Choice C, Adaptive, involves adjusting to new conditions, which is not the primary focus in this scenario. Choice D, Rationalizing, does not fit as the decision made is more about finding an acceptable solution rather than justifying it.

5. The unit manager of a 32-bed medical-surgical unit allows the staff nurses to do self-governance for scheduling, client care assignments, and committee work. The manager would be considered which type of leader?

• A. Autocratic
• B. Democratic
• C. Bureaucratic
• D. Laissez-faire

Correct answer: D

Rationale: The correct answer is D, Laissez-faire. In a laissez-faire leadership style, the manager exerts very little control and allows the staff to have a high degree of autonomy in decision-making and problem-solving. This type of leader provides guidance when needed but largely leaves the decision-making process to the staff. Autocratic leadership (choice A) is characterized by centralizing decision-making authority, democratic leadership (choice B) involves shared decision-making, and bureaucratic leadership (choice C) relies on adherence to rules and procedures.

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