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. A nurse is talking with the partner of a client who has dementia. The client's partner expresses frustration about finding time to manage household responsibilities while caring for their partner. The nurse should identify that the partner is experiencing which of the following types of role-performance stress?

• A. Role ambiguity
• B. Role overload
• C. Role conflict
• D. Sick role

Correct answer: C

Rationale: In this scenario, the partner is struggling to balance caring for their loved one with dementia and managing household responsibilities. This situation represents role conflict, where conflicting demands from different roles (caregiver and homemaker) create stress. Role ambiguity (choice A) refers to uncertainty about what is expected in a role, not conflicting demands. Role overload (choice B) occurs when there are too many responsibilities within a single role, not conflicting roles. The sick role (choice D) is a sociological concept related to the rights and responsibilities of individuals who are ill.

3. Integrated health care systems function in a variety of models. Which of the following is a common characteristic of all systems?

• A. Deliver selective care only
• B. Deliver a whole continuum of care
• C. Treat patients only in the hospital
• D. Provide care only in the primary care setting

Correct answer: B

Rationale: Integrated health care systems are designed to provide a whole continuum of care, which includes preventive, primary, specialty, hospital, and long-term care services. This integration ensures that patients receive comprehensive and coordinated care across different healthcare settings. Choice A is incorrect because integrated systems aim to provide a wide range of services, not selective care only. Choice C is incorrect as integrated systems extend care beyond hospital settings. Choice D is incorrect as these systems offer care across various settings, not limited to primary care only.

4. The problem of overrating staff performance is called ___________ .

• A. Recency error
• B. Absolute judgment
• C. Halo error
• D. Leniency error

Correct answer: D

Rationale: The correct answer is D, 'Leniency error.' Leniency error occurs when a manager tends to overrate staff performance, giving higher ratings than deserved. Choice A, 'Recency error,' refers to the tendency to focus only on recent behaviors or events when evaluating performance. Choice B, 'Absolute judgment,' is not directly related to overrating staff performance; it refers to making evaluations without considering the context or comparison points. Choice C, 'Halo error,' involves allowing one positive aspect of an individual to overshadow other factors in performance evaluation, which is different from overrating overall staff performance.

5. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

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