Nursing Elites

1. Horizontal violence may be observed among staff interactions and causes stress among staff. To minimize stress associated with such interactions, nurses can: (Select all that apply.)

• A. Encourage venting as a way to express feelings.
• B. Take control of the situation by being assertive.
• C. Ignore staff who are volatile.
• D. Avoid interactions with angry staff.

Correct answer: B

Rationale: To minimize stress associated with horizontal violence among staff interactions, nurses should take control of the situation by being assertive. Being assertive allows nurses to address the issues causing stress in a constructive and professional manner. Encouraging venting without addressing the underlying problems may not resolve the situation effectively. Ignoring staff who are volatile can escalate the issue further, and avoiding interactions with angry staff does not address the root cause of the problem. Therefore, being assertive and addressing the situation directly is the most effective approach to minimize stress and promote a healthy work environment.

2. When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the healthcare provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may

• A. require administration of insulin while taking prednisone
• B. develop acute hypoglycemia while taking prednisone
• C. require administration of insulin while taking prednisone
• D. have rashes caused by metformin-prednisone interactions

Correct answer: C

Rationale: When a patient taking metformin develops an allergic rash from an unknown cause and is prescribed prednisone, the nurse should anticipate that the patient may require administration of insulin while taking prednisone. Prednisone can increase blood glucose levels by antagonizing the effects of insulin, leading to hyperglycemia. Therefore, the patient may need additional insulin to manage blood sugar levels effectively. The other options are incorrect as prednisone would not directly cause a need for a higher-calorie diet, acute hypoglycemia, or rashes caused by a metformin-prednisone interaction.

3. The complexities of the current health care delivery systems require a variety of leadership styles. Which of the following leadership styles would be most effective in this environment?

• A. Autocratic leadership
• B. Laissez-faire leadership
• C. Transactional leadership
• D. Transformational leadership

Correct answer: D

Rationale: In complex health care environments, transformational leadership is the most effective style. This leadership approach focuses on inspiring and motivating staff towards a shared vision. Autocratic leadership (choice A) is too controlling and may not foster innovation and adaptability needed in complex systems. Laissez-faire leadership (choice B) lacks guidance and may lead to confusion in intricate healthcare settings. Transactional leadership (choice C) focuses on tasks and rewards, but may not be as effective in promoting innovation and change management required in complex health care delivery systems.

4. Which of the following is a positive benefit of conflict within an organization?

• A. Conflict leads to compromise of values and beliefs.
• B. Conflict leads to intergroup collaboration.
• C. Conflict helps people recognize differences and motivates them towards improved performance.
• D. Conflict always results in a win-win resolution.

Correct answer: C

Rationale: The correct answer is C. Conflict within an organization can have positive outcomes as it helps individuals recognize legitimate differences, fostering diversity of thought and perspectives. This recognition can serve as a motivator for individuals to enhance their performance in order to address and adapt to these differences effectively, ultimately leading to improved organizational outcomes. Choice A is incorrect because conflict should not lead to compromising core values and beliefs. Choice B is incorrect as conflict typically leads to competition rather than collaboration. Choice D is incorrect because conflict does not always result in a win-win resolution; in reality, conflicts often involve compromise and trade-offs rather than everyone winning.

5. An expensive variable in salary budgets is overtime pay. Which of the following is a viable option to reduce overtime?

• A. Limiting overtime for highly paid workers
• B. Reducing the number of beds
• C. Using per diem workers
• D. Refusing to pay overtime

Correct answer: C

Rationale: The correct answer is C: Using per diem workers. By utilizing per diem workers, organizations can flexibly adjust staffing levels based on demand without incurring overtime costs. This approach helps in managing overtime budgets effectively. Choice A is incorrect because limiting overtime for highly paid workers may not address the root cause of overtime expenses. Choice B is incorrect as reducing the number of beds does not directly impact overtime costs. Choice D is not a practical solution as refusing to pay overtime can lead to legal issues and employee dissatisfaction.

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