Nursing Elites

1. Which of the following is a primary responsibility of a nurse case manager?

• A. Direct patient care
• B. Financial planning
• C. Conduct health education
• D. Coordinate patient transitions

Correct answer: D

Rationale: A primary responsibility of a nurse case manager is to coordinate patient transitions. This involves ensuring smooth transitions between healthcare settings, coordinating care plans, and ensuring continuity of care for patients. While direct patient care, financial planning, and health education are important aspects of healthcare, they are not primary responsibilities of a nurse case manager. Nurse case managers focus on managing and coordinating the overall care and services for patients.

2. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

• A. The patient always carries hard candies when engaging in exercise.
• B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
• C. The patient has a peanut butter sandwich before going for a bicycle ride.
• D. The patient increases daily exercise when ketones are present in the urine.

Correct answer: D

Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

3. The complexities of the current health care delivery systems require a variety of leadership styles. Which of the following leadership styles would be most effective in this environment?

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

Correct answer: D

Rationale: In complex health care environments, transformational leadership is the most effective style. This leadership approach focuses on inspiring and motivating staff towards a shared vision. Autocratic leadership (choice A) is too controlling and may not foster innovation and adaptability needed in complex systems. Laissez-faire leadership (choice B) lacks guidance and may lead to confusion in intricate healthcare settings. Transactional leadership (choice C) focuses on tasks and rewards, but may not be as effective in promoting innovation and change management required in complex health care delivery systems.

4. A nurse needs to know how to increase her power base. Which of the following are ways nurses can generate power as described by Umiker?

• A. Using body language, standing when talking
• B. Listening for feelings
• C. Using words, avoiding clichés
• D. All of the above

Correct answer: D

Rationale: The correct answer is D: 'All of the above.' Umiker describes four ways to generate power: using words, through delivery, by listening, and through body language. Choice A is correct as it mentions using body language. Choice B is correct as it mentions listening. Choice C is correct as it pertains to using words effectively and avoiding clichés. Therefore, all the choices are ways nurses can generate power as described by Umiker.

5. Politics is a means for influencing events and the decisions of others. The nurse manager who consistently reminds the staff that 'there is no I in team' and periodically brings treats for the staff is using:

• A. Image enhancement
• B. Political skills
• C. Reward power
• D. Expert power

Correct answer: B

Rationale: The correct answer is B: Political skills. Politics involve interpersonal endeavors, collective activities, analysis, planning, and managing image. In this scenario, the nurse manager is skillfully building team morale and influencing staff dynamics by emphasizing teamwork ('there is no I in team') and boosting morale through occasional treats. This demonstrates the use of political skills to influence and manage relationships within the team. Choices A, C, and D are incorrect because the manager's actions are not solely focused on image enhancement, reward power, or expert power. Instead, they are aimed at fostering teamwork and boosting staff morale.

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