Nursing Elites

1. A client discharges AMA (against medical advice). This is an example of the _________ type of risk category?

• A. nurse-focused
• B. physician-focused
• C. medical-legal incident
• D. Patient-focused

Correct answer: C

Rationale: When a client discharges AMA, it falls under the medical-legal incident risk category. This choice focuses on the legal aspect of the situation, as it involves the patient's right to make decisions about their care, informed consent, and the associated legal implications. Choices A and B are incorrect as they unnecessarily specify individual healthcare roles and do not encompass the broader legal implications of discharging against medical advice. Choice D, patient-focused, is also incorrect as it doesn't capture the legal and risk-related aspects of the scenario.

2. 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.

3. The staff in the emergency department has presented the nurse leader with a suggestion for streamlining the triage process, cutting down on wait times. Which of the following qualities does the leader specifically need to implement the suggestion?

• A. Courage
• B. Integrity
• C. Energy
• D. Initiative

Correct answer: D

Rationale: Initiative is the correct quality needed in this situation. The staff has provided a suggestion for improvement, and the leader must take the initiative to implement it. Courage, integrity, and energy are valuable qualities as well but in this context, the most essential quality is initiative to drive the change forward and improve the triage process efficiently.

4. An RN’s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN’s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: Clients may request a DNR order, but they need to be fully informed of all the ramifications of the decision. Therefore, the health-care provider will consult with the client and family before the order is written.

5. A nurse manager needs to resolve a conflict between the staff nurses and the physical therapy department. What type of power might the manager utilize? (EXCEPT)

• A. Connection and referent power
• B. Reward and punishment power
• C. Legitimate power
• D. Information power

Correct answer: C

Rationale: In this scenario, the nurse manager may utilize various types of power to resolve the conflict between the staff nurses and the physical therapy department. Referent power and connection power are based on respect/admiration and influential links, respectively. Information power is about access to valuable data. Reward power involves offering inducements for cooperation, while punishment power is about imposing penalties for non-compliance. Legitimate power, however, is derived from the manager's authority associated with their job and rank. Since the question asks for the type of power the manager might utilize 'EXCEPT,' legitimate power, being a key type of power often used in managerial roles, is the correct answer. It's important for the nurse manager to understand the dynamics of power and utilize the appropriate types to effectively address interdepartmental conflicts.

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