Nursing Elites

1. When planning to run for the local school board, which of the following sources of power would a nurse find important?

• A. Connection
• B. Reward
• C. Charisma
• D. Expertise

Correct answer: A

Rationale: When a nurse is planning to run for the local school board, the important source of power would be 'Connection.' In politics, building relationships and forming connections are crucial for gaining support, forming coalitions, and accessing valuable information. Being charismatic is not a necessary attribute for utilizing power effectively in this context. While expertise is valuable, especially in education-related matters, it is not specified as a primary source of power for a political candidate. Rewards are not typically within the purview of a candidate running for a position such as the local school board.

2. When should a critical pathway be revised?

• A. When variances show a new trend.
• B. When the variances show a new trend.
• C. When a member of the team retires.
• D. When the client leaves the hospital.

Correct answer: B

Rationale: A critical pathway should be revised when variances in the patient's progress indicate a new trend or deviation from the expected course of treatment. This allows healthcare providers to adjust the pathway to ensure optimal patient care and outcomes. Changes in the critical pathway are not typically driven by its length or external factors like team member retirements or client discharges. Therefore, the correct answer is B. Choice A is a better phrasing of the correct answer, emphasizing the importance of variances showing a new trend. Choices C and D are irrelevant to the patient's progress and treatment plan, making them incorrect.

3. Your values do not coincide with your colleagues. When you report for your shift on nights and staff are not responding to patient requests for pain medication, you, as the nurse responsible for collecting data about patient quality of care, should:

• A. Explain to the nurse manager that quality problems are because of staff apathy.
• B. Issue a memo to staff to assess patients and document their response to the pain medication.
• C. Explain to staff that improving quality is one of your annual goals and you expect them to follow through.
• D. Schedule meetings to engage with staff to monitor pain management.

Correct answer: D

Rationale: As the nurse responsible for collecting data about patient quality of care, it is important to address the issue of staff not responding to patient requests for pain medication. Scheduling meetings to engage with staff to monitor pain management is the most appropriate course of action in this scenario. By enlisting support from staff, reviewing patient satisfaction data, and quality reports about pain management, you can effectively address the issue and improve patient care. Choices A, B, and C are not as effective as they do not involve actively engaging with staff, reviewing data, and working collaboratively to address the problem.

4. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
• B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
• C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
• D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

5. The complexities of the current health care delivery systems require a variety of leadership styles. Which of the following is one that has emerged in response to these changes?

• A. Quantum
• B. Servant
• C. Autocratic
• D. Democratic

Correct answer: A

Rationale: The correct answer is A: Quantum. The quantum theory of leadership addresses complexity in organizations, making it suitable for the challenges posed by the current health care delivery systems. Servant leadership (choice B) focuses on serving others rather than traditional hierarchies, but it is not specifically tailored to address complexities. Autocratic leadership (choice C) and Democratic leadership (choice D) are more traditional styles that may not be as effective in handling the intricacies of modern health care systems.

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