Nursing Elites

1. Healthcare systems primarily have functional structures. Which of the following would be an example of this?

• A. Open communication exists between Physical Therapy and Nursing.
• B. Medicine has authority over nursing.
• C. Laboratory services have little authority.
• D. All nursing tasks fall under nursing service.

Correct answer: D

Rationale: The correct answer is D. In functional structures, employees are grouped in departments by specialty, with similar tasks being performed by the same group. This means that in a healthcare system with a functional structure, all nursing tasks would fall under the nursing service. Choices A, B, and C are incorrect because open communication between departments, one department having authority over another, or the level of authority of a particular department do not necessarily represent a functional structure.

2. Which of the following is a leadership style that assumes individuals are motivated by internal forces and uses participation and majority rule to get work done?

• A. Autocratic leadership
• B. Laissez-faire leadership
• C. Democratic leadership
• D. Transactional leadership

Correct answer: C

Rationale: Democratic leadership is a leadership style that operates on the belief that individuals are motivated by internal forces. It involves encouraging participation and decision-making through majority rule to accomplish tasks. This leadership approach fosters collaboration, empowerment, and involvement of team members in decision-making processes. Autocratic leadership (choice A) is characterized by centralized control and little input from team members. Laissez-faire leadership (choice B) involves minimal interference and provides little guidance or direction. Transactional leadership (choice D) is based on exchanges between leaders and followers for desired outcomes, focusing on rewards and punishments rather than internal motivation and participation.

3. A Staff Nurse submits a six-week notice of resignation. The Nurse Manager prepares a request to immediately post the position and begin interviews. This action is best described as which of the following?

• A. Delegation
• B. A time-waster
• C. Reactive management
• D. Proactive management

Correct answer: D

Rationale: The correct answer is D, Proactive management. Proactive management involves taking steps to prevent issues from occurring rather than just reacting to them. In this scenario, the Nurse Manager is being proactive by preparing to fill the position before the Staff Nurse leaves, thereby preventing short staffing. Choices A, B, and C are incorrect. Delegation refers to assigning tasks to others, not preparing to fill a vacant position. Calling it a time-waster is subjective and not reflective of the manager's proactive approach. Reactive management would involve waiting until the Nurse leaves and then trying to fill the position, causing short staffing.

4. Cultural diversity presents an important challenge to nurse managers due to which of the following?

• A. A nursing shortage exists
• B. Staff nurses are not trained to be culturally sensitive
• C. 80% of nursing staff comes from one or more minority groups
• D. The increase in cultural diversity is seen both in the patient population and the nursing staff

Correct answer: D

Rationale: Cultural diversity presents an important challenge to nurse managers due to the increase in cultural diversity seen both in the patient population and the nursing staff. This challenge requires nurse managers to ensure that their nursing staff can effectively communicate and provide culturally competent care to patients from diverse backgrounds. Choice A is incorrect because it does not directly relate to the impact of cultural diversity. Choice B is incorrect as it focuses on the training of staff nurses rather than the overall challenge of managing cultural diversity. Choice C is incorrect as the percentage of nursing staff from minority groups, while important, is not the primary reason cultural diversity poses a challenge to nurse managers.

5. In which order will the nurse take these steps to prepare NPH 20 units and regular insulin 2 units using the same syringe? (Put a comma and a space between each answer choice [A, B, C, D, E]).

• A. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
• B. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
• C. Rotate NPH vial, Inject 20 units of air into NPH vial, Inject 2 units of air into regular insulin vial, Withdraw regular insulin, Withdraw 20 units of NPH.
• D. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw 20 units of NPH, Inject 2 units of air into regular insulin vial, Withdraw regular insulin.

Correct answer: C

Rationale: The correct order to prepare NPH 20 units and regular insulin 2 units using the same syringe is to start by rotating the NPH vial, then injecting 20 units of air into the NPH vial. Next, inject 2 units of air into the regular insulin vial, followed by withdrawing the regular insulin. Finally, withdraw 20 units of NPH. This sequence ensures proper mixing and preparation of the insulin doses. Choices A, B, and D have incorrect sequences that may lead to incorrect dosages or inadequate mixing of the insulins.

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