Nursing Elites

1. Behavioral leadership theory recognizes three styles of leadership. Which of the following best describes democratic leadership?

• A. The democratic leader communicates meaning and purpose.
• B. The democratic leader gives orders and makes decisions for the group.
• C. The democratic leader does little planning or decision making.
• D. The democratic leader makes plans and decisions with the team.

Correct answer: D

Rationale: Democratic leadership involves the leader working collaboratively with the team to make plans and decisions. This style values input from team members, encourages participation in the decision-making process, and fosters a sense of ownership among the team. Choice A is incorrect because simply communicating meaning and purpose does not capture the essence of democratic leadership. Choice B is incorrect as giving orders and making decisions for the group is more characteristic of an autocratic leadership style. Choice C is incorrect as democratic leaders are actively involved in planning and decision-making processes, contrary to doing little of it.

2. By using ___________ in the workplace, nurses increase their professional influence.

• A. political skills
• B. reward power
• C. expert power
• D. power and politics

Correct answer: C

Rationale: By using expert power in the workplace, nurses increase their professional influence. Expert power is derived from an individual's knowledge, skills, or expertise in a particular area. This allows nurses to influence others based on their competence and credibility, rather than through political skills (choice A), reward power (choice B), or the combination of power and politics (choice D). While political skills and understanding power dynamics can be beneficial, expert power is particularly effective in enhancing a nurse's professional influence.

3. 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.

4. What is the main purpose of a patient satisfaction survey?

• A. To improve patient outcomes
• B. To evaluate nursing performance
• C. To measure patient satisfaction
• D. To assess healthcare facilities

Correct answer: C

Rationale: The main purpose of a patient satisfaction survey is to measure patient satisfaction. These surveys aim to gather feedback directly from patients regarding their experiences and perceptions of the healthcare services they have received. While patient satisfaction may impact outcomes indirectly, the primary goal of the survey is not to directly improve patient outcomes, making choice A incorrect. Choice B is incorrect because patient satisfaction surveys are not primarily focused on evaluating nursing performance specifically. Choice D is also incorrect because the main focus of the survey is on the satisfaction of patients rather than assessing healthcare facilities.

5. An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?

• A. One or more of the parties may be able to reconcile their values.
• B. The patient�s point of view is recognized as valuable.
• C. The dilemma involves two or more equally unpleasant choices.
• D. The institution is unable to honor the patient�s request.

Correct answer: D

Rationale: A patient may make a request that is not possible within the institution. When this occurs, a solution may not be possible within the institution and the patient may need to be transferred to a different institution that may be able to honor the request.

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