Nursing Elites

1. A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?

• A. Increase in hematocrit
• B. Increase in respiratory rate
• C. Decrease in heart rate
• D. Decrease in capillary refill time

Correct answer: D

Rationale: The correct answer is D: Decrease in capillary refill time. In a client with fluid volume deficit, improving capillary refill time indicates that the perfusion status is improving due to the increase in fluid volume. Choices A, B, and C are incorrect. An increase in hematocrit may indicate hemoconcentration due to fluid loss, an increase in respiratory rate may suggest respiratory distress, and a decrease in heart rate may not be directly related to fluid volume status.

2. A recent nursing school graduate is preparing to take the NCLEX. The graduate knows which of the following is true?

• A. Upon graduation from nursing school, she cannot use the title RN.
• B. Because the NCLEX is a national examination, her RN license will allow her to practice in all states and territories of the United States.
• C. If her home state participates in the compact agreement, she may practice in other states participating in the agreement, but should renew her license in her home state.
• D. The RN license is a mandatory license.

Correct answer: C

Rationale: Choice C is correct because if the nurse's home state participates in the compact agreement, she can practice in other states that are part of the agreement, but she must still renew her license in her home state. This is necessary to maintain an active license in her home state. Choice A is incorrect because upon graduation, the nurse can use the title RN if licensed, but it's not automatic. Choice B is incorrect because while the NCLEX is a national exam, the nurse needs to meet individual state requirements for licensure in each state. Choice D is incorrect because an RN license is not permissive but rather a mandatory license to practice nursing.

3. From a unit perspective, disruptive and violent patient behavior may be distracting to patients and staff. As the nurse manager, you are concerned about: (EXCEPT)

• A. Patient and staff safety.
• B. Team tension.
• C. Fear of disappointment.
• D. Stress levels.

Correct answer: C

Rationale: Disruptive and violent patient behavior can indeed pose challenges on a unit. Concerns as a nurse manager would revolve around patient and staff safety (Choice A) due to the risk of harm, team tension (Choice B) arising from managing such situations, and stress levels (Choice D) of both patients and staff. Fear of disappointment (Choice C) is not a typical concern in this scenario and does not directly relate to the immediate impact of disruptive and violent patient behavior.

4. Which leadership style is most effective in a crisis situation?

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

Correct answer: B

Rationale: An autocratic leadership style is most effective in a crisis situation because it allows for quick decision-making without the need for extensive consultation or deliberation. In a crisis, immediate and decisive actions are often required to address the situation effectively. Democratic leadership, on the other hand, may slow down the decision-making process due to the need for consensus and input from team members. Transformational leadership focuses on inspiring and motivating followers, which may not always be as effective in a crisis where urgent actions are needed. Laissez-faire leadership, characterized by a hands-off approach, is generally ineffective in crisis situations as it lacks the necessary direction and guidance required to navigate through the challenges efficiently.

5. A nurse manager is using the nominal group technique to gather input from the staff on a new policy. What is the primary method of exchange in this technique?

• A. Oral presentations
• B. Email exchanges
• C. Written reports
• D. Group discussions

Correct answer: C

Rationale: In the nominal group technique, the primary method of exchange is through written reports. Participants independently generate ideas in writing, which are then shared and discussed within the group. This structured process allows for equal participation and prevents dominant individuals from influencing the group's outcome. Oral presentations (choice A) involve speaking rather than written communication, making it less suitable for the nominal group technique. Email exchanges (choice B) are also not the primary method as they lack the structured approach of the nominal group technique. Group discussions (choice D) do occur in the nominal group technique but are secondary to the initial written idea generation phase.

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