Nursing Elites

1. The unit manager of a 32-bed medical-surgical unit allows the staff nurses to do self-governance for scheduling, client care assignments, and committee work. The manager would be considered which type of leader?

• A. Autocratic
• B. Democratic
• C. Bureaucratic
• D. Laissez-faire

Correct answer: D

Rationale: The correct answer is D, Laissez-faire. In a laissez-faire leadership style, the manager exerts very little control and allows the staff to have a high degree of autonomy in decision-making and problem-solving. This type of leader provides guidance when needed but largely leaves the decision-making process to the staff. Autocratic leadership (choice A) is characterized by centralizing decision-making authority, democratic leadership (choice B) involves shared decision-making, and bureaucratic leadership (choice C) relies on adherence to rules and procedures.

2. The staff nurse delegates AM care for two patients to the UAP (Unlicensed Assistive Person). What principle of delegation is the nurse following?

• A. Delegation requires a situation with clearly defined superiors.
• B. Delegation can only exist with a subordinate.
• C. Delegation is a tool used by various healthcare professionals.
• D. You can delegate only those tasks.

Correct answer: D

Rationale: The correct answer is D: 'You can delegate only those tasks.' Delegation in nursing involves transferring responsibility for the performance of a task while retaining accountability for the outcome. The principle of delegation does not require a situation with clearly defined superiors (choice A). Delegation can exist not only with a subordinate but also with colleagues or other healthcare team members (choice B). Delegation is not exclusive to nurses and is a tool used by various healthcare professionals (choice C). Therefore, the best choice is D as it accurately reflects the principle of delegation in nursing.

3. Which of the following is one of the positive benefits of conflict within an organization?

• A. Conflict leads to compromise on values and beliefs.
• B. Conflict leads to intergroup competition.
• C. Conflict helps people recognize differences and motivates people towards improved performance.
• D. Conflict always leads to a win-win resolution.

Correct answer: C

Rationale: The correct answer is C. Conflict within an organization can help people recognize legitimate differences and motivate them towards improved performance. This recognition of differences can lead to constructive discussions and solutions. Choice A is incorrect because conflict does not necessarily always lead to compromising values and beliefs. Choice B is incorrect as conflict should not be about fostering intergroup competition but rather about addressing and resolving issues. Choice D is incorrect as conflicts do not always result in a win-win resolution; sometimes, compromises or trade-offs are necessary for resolution.

4. An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN�s friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying?

• A. Fidelity
• B. Confidentiality
• C. Veracity
• D. Accountability

Correct answer: B

Rationale: The principle of confidentiality requires nurses to hold healthcare information and anything patients tell them in the strictest confidence.

5. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: Clients may request a DNR order, but they need to be fully informed of all the ramifications of the decision. Therefore, the health-care provider will consult with the client and family before the order is written.

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