Nursing Elites

1. Which of the following best describes the concept of shared governance?

• A. Top-down management
• B. Nurse-led committees
• C. Shared decision making
• D. Hierarchical structure

Correct answer: C

Rationale: The correct answer is C: 'Shared decision making.' Shared governance in healthcare involves empowering nurses to participate in decision-making processes that affect their practice. This model fosters collaboration, transparency, and accountability among healthcare providers. Choice A, 'Top-down management,' is incorrect because shared governance promotes a bottom-up approach. Choice B, 'Nurse-led committees,' is partially correct as it is a component of shared governance, but the core concept is broader and encompasses shared decision making beyond committee leadership. Choice D, 'Hierarchical structure,' is incorrect as shared governance aims to flatten hierarchies and distribute decision-making authority among healthcare team members.

2. What innate tendency influences staff to act in a certain way?

• A. Instinct
• B. Appreciation
• C. Control
• D. Esteem

Correct answer: A

Rationale: The correct answer is A: Instinct. Instinct theory suggests that behaviors are influenced by inherited or innate tendencies, guiding individuals to act in specific ways without conscious reasoning. In the context of staff behavior, instinct can play a significant role in shaping their actions and responses. Choices B, C, and D are incorrect. Appreciation, control, and esteem are external factors that may influence staff behavior, but in this context, the question specifically asks for an innate tendency that influences staff to act in a certain way, which aligns more closely with instinctive tendencies rather than external factors like appreciation, control, or esteem.

3. 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.

4. Which of the following presents an important emerging challenge to changes in health care?

• A. Decreased immigration
• B. Nursing staff shortages
• C. Bioterrorism
• D. Increased surgical procedures

Correct answer: C

Rationale: Bioterrorism is considered an important emerging challenge to changes in health care due to its potential to disrupt healthcare systems, cause mass casualties, and create public health emergencies. Choices A, B, and D are not directly related to emerging challenges in health care. While nursing staff shortages are a significant issue, bioterrorism poses a different kind of threat that requires specific preparedness and response strategies.

5. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?

• A. BUN 21 mg/dL (10 to 20 mg/dL)
• B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
• C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
• D. Sodium 132 mEq/L (136 to 145 mEq/L)

Correct answer: B

Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.

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