Nursing Elites

1. When is the first opportunity for a manager to reduce turnover?

• A. When the decision to hire a new employee is made
• B. After one month of employment
• C. After three months of employment
• D. After a certain tenure period

Correct answer: C

Rationale: The manager's first opportunity to reduce turnover occurs after three months of employment. During this period, the manager can assess the employee's performance, engagement, and fit within the organization. It allows the manager to address any concerns, provide support, and intervene early to prevent turnover. Waiting until after a certain tenure period might be too late to effectively mitigate turnover risk, as issues could have already escalated. Therefore, the three-month mark is a critical point for managers to proactively manage turnover. Choices A and B are incorrect because they do not allow sufficient time for the manager to evaluate the employee and take proactive measures to reduce turnover. Choice D is incorrect as it is too vague and does not provide a specific actionable timeframe for addressing turnover concerns.

2. A client who is nonambulatory notifies the nurse that their trash can is on fire. After the nurse confirms the presence of the fire, which of the following actions should the nurse take next?

• A. Activate the emergency fire alarm.
• B. Extinguish the fire.
• C. Evacuate the client.
• D. Confine the fire.

Correct answer: D

Rationale: In this situation, the nurse's priority should be to confine the fire. By confining the fire, the nurse can prevent it from spreading further and causing more harm. Activating the emergency fire alarm (choice A) is important but should come after confining the fire. Extinguishing the fire (choice B) might not be safe for the nurse to do without proper equipment and training. Evacuating the client (choice C) can be considered once the fire is confined to ensure the client's safety.

3. Which of the following best describes the concept of patient-centered care?

• A. Care that is directed solely by healthcare providers
• B. Care that involves coordination among multiple healthcare providers
• C. Care that prioritizes the patient's preferences, needs, and values
• D. Care that strictly adheres to the latest clinical guidelines

Correct answer: C

Rationale: Patient-centered care is a healthcare approach that places the patient at the center of decision-making, emphasizing their preferences, needs, and values. This approach ensures that care is tailored to individual patients, taking into account their unique circumstances and actively involving them in their own care. Choice A is incorrect because patient-centered care focuses on the patient's needs rather than being solely directed by healthcare providers. Choice B is incorrect as involving multiple healthcare providers doesn't necessarily mean care is patient-centered; instead, it's about tailoring care to the patient's individual needs. Choice D is also incorrect as patient-centered care goes beyond just following clinical guidelines to encompass individual patient preferences and values.

4. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

• A. give a bolus of 50% dextrose.
• B. insert a large-bore IV catheter.
• C. initiate oxygen via nasal cannula.
• D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

5. A nurse manager needs to resolve a conflict between the staff nurses and the physical therapy department. What type of power might the manager utilize? (EXCEPT)

• A. Connection and referent power
• B. Reward and punishment power
• C. Legitimate power
• D. Information power

Correct answer: C

Rationale: In this scenario, the nurse manager may utilize various types of power to resolve the conflict between the staff nurses and the physical therapy department. Referent power and connection power are based on respect/admiration and influential links, respectively. Information power is about access to valuable data. Reward power involves offering inducements for cooperation, while punishment power is about imposing penalties for non-compliance. Legitimate power, however, is derived from the manager's authority associated with their job and rank. Since the question asks for the type of power the manager might utilize 'EXCEPT,' legitimate power, being a key type of power often used in managerial roles, is the correct answer. It's important for the nurse manager to understand the dynamics of power and utilize the appropriate types to effectively address interdepartmental conflicts.

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