Nursing Elites

1. Which of the following is a leadership style that assumes individuals are motivated by internal forces and uses participation and majority rule to get work done?

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

Correct answer: C

Rationale: Democratic leadership is a leadership style that operates on the belief that individuals are motivated by internal forces. It involves encouraging participation and decision-making through majority rule to accomplish tasks. This leadership approach fosters collaboration, empowerment, and involvement of team members in decision-making processes. Autocratic leadership (choice A) is characterized by centralized control and little input from team members. Laissez-faire leadership (choice B) involves minimal interference and provides little guidance or direction. Transactional leadership (choice D) is based on exchanges between leaders and followers for desired outcomes, focusing on rewards and punishments rather than internal motivation and participation.

2. The staff nurse is caring for the client with total accountability and is in continual communication with the client, the family, the physicians, and other members of the health care team. This type of nursing delivery system is known as:

• A. Total patient care
• B. Qualified nurse case managers
• C. Established critical pathways
• D. Quality management system

Correct answer: A

Rationale: The correct answer is A: Total patient care. Total patient care is the original model of nursing care delivery, in which one RN has complete responsibility for all aspects of care for one or more patients. In this system, the nurse is accountable for the client's care and maintains continuous communication with the client, their family, physicians, and other healthcare team members. Choice B, Qualified nurse case managers, refers to nurses who coordinate care but do not provide direct hands-on patient care. Choice C, Established critical pathways, involves predefined care plans for specific conditions but does not imply direct accountability as in total patient care. Choice D, Quality management system, relates to processes to ensure and enhance the quality of care but is not specifically about the direct provision of patient care.

3. Which of the following conditions would be well suited to the use of a nursing critical pathway?

• A. Foreign object in the ear
• B. Fever of unknown origin
• C. Hip replacement surgery
• D. Bacterial infection acquired in a foreign country

Correct answer: C

Rationale: A critical pathway is designed to track a patient's progress through a specific timeline, including assessments, interventions, treatments, and outcomes. Hip replacement surgery is well suited for a nursing critical pathway because it has a defined timeline with specific interventions and treatments aimed at achieving optimal functioning. Choices A, B, and D do not typically follow a structured timeline with predetermined interventions and outcomes, making them less suitable for a critical pathway.

4. You believe that you are working harder than other nurses and that you take care of patients that are more complex. You are angry that other staff nurses have less complex and lower acuity patients, but you __________ .

• A. Avoid discussing the situation because you do not want to be perceived as a complainer.
• B. Know that you need to discuss the inequity with the nurse manager because you are resenting the work and becoming more dissatisfied in your job
• C. A & B
• D. None of the above

Correct answer: C

Rationale: Professionals communicate their views in a respectful and direct manner. In discussing the situation with the manager, professionals may gain insights about their reactions to stress and how they can cope with the intense demands of the healthcare environment. Choice A is incorrect because avoiding discussing the situation does not address the underlying issue and may lead to increased frustration. Choice B is correct as it emphasizes the importance of addressing the inequity with the nurse manager to find a constructive solution. Choice D is incorrect as it does not provide any guidance on how to handle the situation effectively.

5. One of the most important driving forces behind health care policy changes is which of the following?

• A. New technology
• B. Outsourcing of services
• C. Emerging role of nurse practitioners
• D. Ability to pay for health care

Correct answer: D

Rationale: The correct answer is D, 'Ability to pay for health care.' One of the primary factors influencing health care policy changes is the financial aspect, as the ability to afford healthcare services affects access, quality, and equity. While new technology, outsourcing of services, and the emerging role of nurse practitioners may also impact health care policies, the fundamental driver often revolves around individuals' and societies' financial capacity to pay for healthcare.

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