Nursing Elites

1. A nurse needs to know how to increase her power base. Which of the following are ways nurses can generate power as described by Umiker?

• A. Using body language, standing when talking
• B. Listening for feelings
• C. Using words, avoiding clichés
• D. All of the above

Correct answer: D

Rationale: The correct answer is D: 'All of the above.' Umiker describes four ways to generate power: using words, through delivery, by listening, and through body language. Choice A is correct as it mentions using body language. Choice B is correct as it mentions listening. Choice C is correct as it pertains to using words effectively and avoiding clichés. Therefore, all the choices are ways nurses can generate power as described by Umiker.

2. A Staff Nurse submits a six-week notice of resignation. The Nurse Manager prepares a request to immediately post the position and begin interviews. This action is best described as which of the following?

• A. Delegation
• B. A time-waster
• C. Reactive management
• D. Proactive management

Correct answer: D

Rationale: The correct answer is D, Proactive management. Proactive management involves taking steps to prevent issues from occurring rather than just reacting to them. In this scenario, the Nurse Manager is being proactive by preparing to fill the position before the Staff Nurse leaves, thereby preventing short staffing. Choices A, B, and C are incorrect. Delegation refers to assigning tasks to others, not preparing to fill a vacant position. Calling it a time-waster is subjective and not reflective of the manager's proactive approach. Reactive management would involve waiting until the Nurse leaves and then trying to fill the position, causing short staffing.

3. A 34-year-old has a new diagnosis of type 2 diabetes. The nurse will discuss the need to schedule a dilated eye exam

• A. every 2 years
• B. as soon as possible
• C. when the patient is 39 years old
• D. within the first year after diagnosis

Correct answer: B

Rationale: The correct answer is 'B' - as soon as possible. Patients with type 2 diabetes should have a dilated eye exam shortly after diagnosis to check for any signs of diabetic retinopathy, a common complication of diabetes. Waiting for 2 years (choice A) may lead to missing early signs of eye damage. Choice C is incorrect as there is no specific age requirement mentioned for the eye exam. Choice D is also incorrect because early detection and intervention are crucial in diabetic eye disease.

4. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

• A. Hypotension
• B. Distended neck veins
• C. Slow capillary refill
• D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

5. A client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?

• A. Continuous quality improvement
• B. Total quality management
• C. Six Sigma
• D. Quality management

Correct answer: B

Rationale: Total Quality Management (TQM) emphasizes meeting customer needs and satisfaction. In this scenario, by honoring the client's request to delay care to allow for rest, the nurse is aligning with the customer-focused approach of TQM. TQM seeks to continuously improve processes and services to enhance customer experiences and outcomes. Continuous Quality Improvement focuses on incremental improvements in processes and outcomes over time. Six Sigma is a data-driven approach to process improvement that aims to reduce defects and errors. Quality Management is a broader concept that encompasses various strategies to ensure quality standards are met.

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