Nursing Elites

1. Behavioral leadership theory recognizes three styles of leadership. Which of the following best describes democratic leadership?

• A. The democratic leader communicates meaning and purpose.
• B. The democratic leader gives orders and makes decisions for the group.
• C. The democratic leader does little planning or decision making.
• D. The democratic leader makes plans and decisions with the team.

Correct answer: D

Rationale: Democratic leadership involves the leader working collaboratively with the team to make plans and decisions. This style values input from team members, encourages participation in the decision-making process, and fosters a sense of ownership among the team. Choice A is incorrect because simply communicating meaning and purpose does not capture the essence of democratic leadership. Choice B is incorrect as giving orders and making decisions for the group is more characteristic of an autocratic leadership style. Choice C is incorrect as democratic leaders are actively involved in planning and decision-making processes, contrary to doing little of it.

2. Professionalism has historically been difficult to define. Early definitions of professionalism included which of the following characteristics?

• A. Expertise
• B. Empathy
• C. Ethical and moral values
• D. Honesty

Correct answer: A

Rationale: The correct answer is A: 'Expertise.' Historically, professionalism was defined by one's knowledge and expertise in a particular field. Choices B, C, and D are incorrect because early definitions of professionalism did not focus on qualities like empathy, ethical and moral values, or honesty, but rather on the individual's level of skill and competence in their area of work.

3. A 26-year-old patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to administer the morning insulin?

• A. Thigh
• B. Buttock
• C. Abdomen
• D. Upper arm

Correct answer: C

Rationale: The correct answer is the abdomen. When a patient engages in physical activities like riding a bicycle, the abdomen is a suitable site for insulin administration due to the consistent absorption rate. The subcutaneous tissue in the abdomen allows for more predictable insulin absorption compared to other sites. The thigh is also a common site for insulin injection but may not be ideal for this patient due to the physical activity involved. The buttock and upper arm are not preferred sites for insulin injection as they can have variable absorption rates and may not be as convenient for self-administration.

4. 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.

5. If a staff member does not respond to discipline, the manager must ______ employment.

• A. Terminate
• B. Confront
• C. Describe the staff nurse's behavior that violated the policy
• D. Determine the employee's awareness of the policy

Correct answer: A

Rationale: When an employee does not respond to disciplinary measures, termination may be necessary. This is a last resort for managers when other strategies to improve performance have failed. Terminating an employee means ending their employment with the organization. Choices B, C, and D are incorrect as the question specifically asks what action the manager must take when an employee does not respond to discipline. Confronting the employee, describing the behavior, or determining awareness of the policy are steps that may precede termination but are not the final action to be taken.

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