Nursing Elites

1. Which of the following is an example of a clinical decision support system (CDSS)?

• A. Electronic health record (EHR)
• B. Barcode medication administration
• C. Smart infusion pumps
• D. Automated drug dispensing system

Correct answer: C

Rationale: The correct answer is C, smart infusion pumps. Smart infusion pumps are an example of a clinical decision support system (CDSS) as they help ensure accurate medication delivery by providing alerts and dosage calculations. Choice A, electronic health record (EHR), is not a CDSS but rather a digital version of a patient's paper chart. Choice B, barcode medication administration, involves scanning barcodes to verify medication administration but is not a CDSS. Choice D, automated drug dispensing system, automates the medication dispensing process but is not specifically a CDSS.

2. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

• A. use only the lispro insulin until the symptoms are resolved
• B. limit calorie intake until the glucose is less than 120 mg/dL
• C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
• D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%

Correct answer: C

Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.

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. Under which category does a violation of the nurse practice act fall?

• A. Juvenile
• B. Felony
• C. Misdemeanor
• D. Tort

Correct answer: B

Rationale: A violation of the nurse practice act falls under the category of a felony. Felony offenses are the most serious and can include acts like homicide and violations of professional practice regulations. Choices A, C, and D are incorrect because violations of the nurse practice act are considered more severe than misdemeanors, torts, or related to juvenile cases.

5. The unit manager of a 32-bed medical-surgical unit allows the staff nurses to do self-governance for scheduling, client care assignments, and committee work. The manager would be considered which type of leader?

• A. Autocratic
• B. Democratic
• C. Bureaucratic
• D. Laissez-faire

Correct answer: D

Rationale: The correct answer is D, Laissez-faire. In a laissez-faire leadership style, the manager exerts very little control and allows the staff to have a high degree of autonomy in decision-making and problem-solving. This type of leader provides guidance when needed but largely leaves the decision-making process to the staff. Autocratic leadership (choice A) is characterized by centralizing decision-making authority, democratic leadership (choice B) involves shared decision-making, and bureaucratic leadership (choice C) relies on adherence to rules and procedures.

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