Nursing Elites

1. The staff nurse delegates AM care for two patients to the UAP (Unlicensed Assistive Person). What principle of delegation is the nurse following?

• A. Delegation requires a situation with clearly defined superiors.
• B. Delegation can only exist with a subordinate.
• C. Delegation is a tool used by various healthcare professionals.
• D. You can delegate only those tasks.

Correct answer: D

Rationale: The correct answer is D: 'You can delegate only those tasks.' Delegation in nursing involves transferring responsibility for the performance of a task while retaining accountability for the outcome. The principle of delegation does not require a situation with clearly defined superiors (choice A). Delegation can exist not only with a subordinate but also with colleagues or other healthcare team members (choice B). Delegation is not exclusive to nurses and is a tool used by various healthcare professionals (choice C). Therefore, the best choice is D as it accurately reflects the principle of delegation in nursing.

2. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation that should be included in the reminders for ensuring legally credible nursing documentation is to 'Only use approved abbreviations.' Using shortcuts in documentation (Choice A) may lead to incomplete or vague information, compromising the credibility of documentation. Documentation should not be subjective (Choice C) but rather objective and based on factual information. While it is important to document after care is provided (Choice D), the immediate documentation following care provision is critical for accuracy and legal credibility.

3. Which of the following is an example of voluntary absenteeism?

• A. Staying home for a sick child
• B. Staying home for a funeral
• C. Staying home to run errands or finish housework
• D. Staying home for sickness

Correct answer: C

Rationale: The correct answer is C, 'Staying home to run errands or finish housework.' Voluntary absenteeism refers to absences that are within the employee's control. Running errands or completing housework are choices an employee makes, unlike being absent due to sickness or a funeral, which are events beyond the employee's control. Choices A, B, and D involve reasons for absence that are not voluntary as they are influenced by external circumstances, such as illness or family emergencies.

4. Which of the following best describes the concept of evidence-based management?

• A. Using personal experience to make managerial decisions
• B. Combining managerial expertise with the latest research evidence
• C. Using intuition and experience to guide management decisions
• D. Relying on peer-reviewed literature to inform management practices

Correct answer: B

Rationale: The concept of evidence-based management involves combining managerial expertise with the latest research evidence to make informed decisions. Choice A is incorrect because relying solely on personal experience may not align with the best available evidence. Choice C is incorrect as it emphasizes intuition over research evidence. Choice D is incorrect because evidence-based management involves not only peer-reviewed literature but also incorporating managerial expertise.

5. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

• A. give a bolus of 50% dextrose.
• B. insert a large-bore IV catheter.
• C. initiate oxygen via nasal cannula.
• D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

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