Nursing Elites

1. Which of the following leaders would be considered a transformational leader?

• A. The supervisor of a unit who requests staff to work overtime.
• B. The unit secretary who encourages staff to use the proper forms.
• C. A unit manager who reminds a CNA (Certified Nursing Assistant) to work on time management skills.
• D. The Advanced Practice Nurse who encourages a staff nurse to pursue additional education for career advancement.

Correct answer: D

Rationale: The correct answer is D because transformational leaders are known for inspiring and motivating their followers to reach their full potential. They focus on fostering a positive work environment, encouraging growth, and supporting career development. In this scenario, the Advanced Practice Nurse is displaying characteristics of a transformational leader by encouraging a staff nurse to pursue additional education for career advancement. Choices A, B, and C do not align with the traits of a transformational leader as they involve more routine tasks or directives without the inspirational and visionary approach typical of transformational leadership.

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. 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.

4. What is the main purpose of a clinical audit?

• A. To measure patient satisfaction
• B. To evaluate the effectiveness of clinical practices
• C. To identify areas for improvement
• D. To standardize patient care protocols

Correct answer: C

Rationale: The main purpose of a clinical audit is to identify areas for improvement in clinical practices. While patient satisfaction might be a component evaluated during an audit, the primary goal is to ensure that care is safe, effective, and patient-centered, rather than solely focusing on satisfaction. Evaluating the effectiveness of clinical practices is a related but more specific goal compared to the broader aim of identifying areas for improvement. Standardizing patient care protocols can be a result of a clinical audit, but it is not the main purpose, which is to pinpoint areas needing enhancement.

5. Which of the following are significant benefits to an organization that is considering adoption of a practice partnership model? (Select all that apply.)

• A. Clients express reduced satisfaction.
• B. It is less expensive to implement than other models.
• C. Continuity of care is facilitated.
• D. Leadership is well accepted.

Correct answer: C

Rationale: The correct answer is C: Continuity of care is facilitated. One of the significant benefits of a practice partnership model is that it facilitates continuity of care, which can lead to better outcomes for clients. Choice A is incorrect as clients would not express reduced satisfaction with this model; in fact, greater client satisfaction is a benefit. Choice B is incorrect because the cost-effectiveness of the model is not specified or guaranteed. Choice D is incorrect as the acceptance of leadership is not explicitly mentioned as a significant benefit of this model.

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