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. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

• A. Avoid snacking at bedtime.
• B. Increase the rapid-acting insulin dose.
• C. Check the blood glucose during the night.
• D. Administer a larger dose of long-acting insulin.

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

3. In the scenario where a family member slips on the wet floor and hits her head, what hospital process requires completion of an incident report?

• A. Risk management
• B. Outcome management
• C. Quality management
• D. Peer review

Correct answer: A

Rationale: In healthcare settings, completing an incident report is a crucial aspect of risk management. Risk management aims to identify, assess, and mitigate risks to prevent harm to patients, visitors, or staff. Incident reports provide valuable data for analyzing events, implementing corrective actions, and improving patient safety within the healthcare facility. Choices B, C, and D are incorrect because outcome management focuses on achieving desired results, quality management concentrates on maintaining high standards of care, and peer review involves evaluating the performance of healthcare providers, none of which directly relate to the completion of an incident report due to an accident.

4. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?

• A. Urine dipstick for glucose
• B. Oral glucose tolerance test
• C. Fasting blood glucose level
• D. Glycosylated hemoglobin level

Correct answer: D

Rationale: The correct answer is D: Glycosylated hemoglobin level. Glycosylated hemoglobin, also known as hemoglobin A1c, provides a long-term indicator of blood glucose control over the past 2-3 months. It is a valuable tool in assessing the effectiveness of diabetes treatment because it reflects average blood sugar levels during this period. Choices A, B, and C are not as effective for evaluating long-term glucose control. Urine dipstick for glucose only provides a snapshot of glucose levels at the time of testing, oral glucose tolerance test evaluates how the body processes glucose after drinking a sugary solution, and fasting blood glucose level gives a point-in-time measurement of glucose levels after fasting, but they do not reflect the overall glucose control over several months.

5. What is the main concern with collective bargaining?

• A. Create tension among nurses.
• B. Reform health care.
• C. Secure economic security.
• D. Unite the nurses.

Correct answer: A

Rationale: The main concern with collective bargaining is that it can create tension among nurses. The bargaining process may lead to divisions between staff nurses and management, rather than uniting them. This tension can arise from differing priorities, goals, or interests between the two groups, potentially impacting the effectiveness of the bargaining process. Choices B, C, and D are incorrect because the primary focus of the concern is on the potential negative impact on nurse relationships, not on reforming healthcare, ensuring economic security, or uniting nurses.

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