Nursing Elites

1. Which of the following types of leadership behaviors would be most useful when managing a staff of newly trained CNAs (Certified Nursing Assistants)?

• A. Achievement-oriented
• B. Supportive
• C. Participative
• D. Directive

Correct answer: D

Rationale: The most useful type of leadership behavior when managing a staff of newly trained CNAs (Certified Nursing Assistants) would be directive. Directive leadership involves giving specific guidance, ensuring adherence to rules and procedures, scheduling work efforts, and clearly telling employees what is expected. This approach is particularly beneficial for newly trained staff who may require clear instructions and guidance. - Achievement-oriented leadership focuses on setting challenging goals and encouraging employees to reach their highest potential. While this can be beneficial in some situations, it may not be the most suitable for managing newly trained CNAs who require more guidance and direction. - Supportive leadership involves providing emotional support, encouragement, and assistance to employees. While emotional support is essential in any work environment, newly trained CNAs may benefit more from clear direction and guidance. - Participative leadership involves involving employees in decision-making processes. While this can promote employee engagement and empowerment, newly trained CNAs may require more structured guidance and direction to ensure they understand their roles and responsibilities.

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. What term refers to the situation where the pay of newer employees is similar to or higher than that of more experienced employees?

• A. Salary compression
• B. Salary expectations
• C. Salary range
• D. Salary inflation

Correct answer: A

Rationale: Salary compression is the term used to describe the situation where the pay of newer employees is similar to or higher than that of more experienced employees. This can happen when newer employees are paid higher salaries to attract them, leading to a compressed salary structure in the organization. Choice B, 'Salary expectations,' does not specifically refer to the scenario described in the question. Choice C, 'Salary range,' is a broader term referring to the range of salaries offered for a particular job or position, not specifically related to the disparity between new and experienced employees. Choice D, 'Salary inflation,' does not accurately describe the situation of newer employees earning higher salaries than more experienced ones; instead, it refers to a general increase in wages across the board.

4. The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions would be which of the following strategies?

• A. Verifying through feedback
• B. Follow-up communication
• C. Getting positive attention
• D. Knowing the context of the instruction

Correct answer: A

Rationale: Asking the subordinate to repeat the instructions is a strategy known as verifying through feedback. This approach ensures that the receiver has understood the request correctly. Choice B, 'Follow-up communication,' refers to checking in after the initial communication, not necessarily asking for repetition. Choice C, 'Getting positive attention,' is unrelated to confirming understanding. Choice D, 'Knowing the context of the instruction,' deals with understanding the background or reasons behind the instructions, not confirming comprehension.

5. What is the primary reason for conducting a performance appraisal?

• A. Providing constructive feedback.
• B. Imposing punishment.
• C. Identifying issues.
• D. Offering coaching.

Correct answer: A

Rationale: The primary reason for conducting a performance appraisal is to provide constructive feedback to employees. This feedback helps employees understand what is expected of them, how well they are performing, and areas where they can improve. Choice B (Imposing punishment) is incorrect because performance appraisals should focus on development rather than punishment. Choice C (Identifying issues) is not the primary reason but can be a secondary outcome of performance appraisals. Choice D (Offering coaching) is related to providing guidance and support, which is a part of the feedback process but not the primary reason for conducting a performance appraisal.

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