Nursing Elites

1. When planning a budget, the nurse manager knows that costs depend on and change in direct proportion to patient volume and activity. What type of costs are these?

• A. Variable costs
• B. Indirect costs
• C. Fixed costs
• D. Direct costs

Correct answer: A

Rationale: Variable costs vary in direct proportion to patient volume and activity. These costs increase or decrease based on the level of patient care provided. Indirect costs are not directly tied to patient volume, fixed costs remain constant regardless of patient volume, and direct costs are directly attributable to patient care but may not vary with patient volume and activity. Therefore, the correct answer is 'Variable costs.'

2. 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.

3. Monitoring the number of times a medication is given utilizing the 'five rights' is an example of which phase of the Six Sigma program?

• A. Measure
• B. Management
• C. Quantitative
• D. Goal

Correct answer: A

Rationale: In the Six Sigma program, the 'Measure' phase focuses on monitoring and measuring processes to ensure they meet the desired standards. This includes tracking the number of times a medication is given correctly using the 'five rights' principle. Therefore, the correct answer is A. Choice B, 'Management,' does not specifically relate to monitoring processes or data collection, so it is not the correct answer. Choice C, 'Quantitative,' refers to the use of numerical data in decision-making, which is a broader concept and not specific to monitoring processes within the Six Sigma framework. Choice D, 'Goal,' is too general and does not capture the specific phase of Six Sigma that involves monitoring and measuring processes.

4. 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.

5. When seeking their first nursing job, what is the most important factor that nursing graduates look for?

• A. Location
• B. Money
• C. Orientation
• D. Vacation

Correct answer: C

Rationale: The correct answer is C: Orientation. Nursing graduates prioritize the orientation program when seeking their first job as it helps them transition smoothly into their new role. Choices A, B, and D are incorrect. While location, salary, and vacation time are important considerations, nursing graduates specifically value a comprehensive orientation program to support their initial professional development.

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