Nursing Elites

1. A nurse manager is interested in solving a serious conflict that exists among the nursing staff. He uses a strategy that involves allowing the group to explore a number of solutions and come to a consensus on a solution. What strategy for conflict resolution has the manager used?

• A. Integrative decision-making
• B. Win-win
• C. Competing
• D. Confrontation

Correct answer: A

Rationale: The correct answer is A: Integrative decision-making. Integrative decision-making involves allowing a group to explore various solutions and work together to reach a consensus. This strategy focuses on collaboration and finding a solution that meets the needs of all parties involved. Choices B, C, and D are incorrect. 'Win-win' is another term for integrative decision-making, 'Competing' involves pursuing one's own interests at the expense of others, and 'Confrontation' implies a direct conflict rather than a collaborative approach to resolution.

2. Which of the following best describes the role of a clinical nurse specialist (CNS)?

• A. Direct patient care provider
• B. Administrator of healthcare facilities
• C. Consultant for nursing staff
• D. Policy maker in healthcare organizations

Correct answer: C

Rationale: The correct answer is C. A clinical nurse specialist (CNS) serves as a consultant for nursing staff, providing expert advice and guidance on clinical practice. Choice A, 'Direct patient care provider,' is incorrect as CNS typically focus more on education, research, and consultation rather than direct patient care. Choice B, 'Administrator of healthcare facilities,' is incorrect as this role is usually fulfilled by nurse administrators or nurse managers. Choice D, 'Policy maker in healthcare organizations,' is incorrect as policy-making roles are typically held by individuals in healthcare administration or government positions.

3. Which of the following is an example of a conflict of interest in nursing?

• A. A nurse accepting gifts from a patient
• B. A nurse working for two competing healthcare organizations
• C. A nurse disclosing patient information without consent
• D. A nurse delegating tasks improperly

Correct answer: B

Rationale: The correct answer is B. A nurse working for two competing healthcare organizations represents a conflict of interest as it may affect impartiality. Choice A is incorrect as accepting gifts from a patient may be a violation of ethical standards, but it is not a conflict of interest. Choice C is incorrect as disclosing patient information without consent is a breach of confidentiality, not a conflict of interest. Choice D is incorrect as delegating tasks improperly relates to professional competence, not a conflict of interest.

4. What is the primary focus of case management in nursing?

• A. Direct patient care
• B. Resource management
• C. Financial planning
• D. Quality assurance

Correct answer: A

Rationale: The primary focus of case management in nursing is direct patient care, which involves providing and coordinating services for patients. While resource management, financial planning, and quality assurance are important aspects of healthcare, they are not the primary focus of case management. Resource management deals with optimizing resources, financial planning involves managing financial aspects, and quality assurance focuses on maintaining high standards of care.

5. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?

• A. Hemoglobin A1C level is 7.9%.
• B. Last eye exam was 18 months ago.
• C. Glomerular filtration rate is decreased.
• D. Patient has questions about the prescribed diet.

Correct answer: C

Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.

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