Nursing Elites

1. Which of the following can cause negative effects on decision making among groups?

• A. Rationalization
• B. Groupthink
• C. Risky shift
• D. Dialectical inquiry

Correct answer: B

Rationale: The correct answer is B: Groupthink. Groupthink is a negative phenomenon occurring in highly cohesive, isolated groups where members tend to think alike, which hinders critical thinking and can lead to poor decision-making. Rationalization refers to justifying or explaining behaviors or decisions in a logical manner. Risky shift is a phenomenon in groups where decisions become riskier or more extreme than individual members would make on their own. Dialectical inquiry is a technique used to counteract groupthink by encouraging debate and presenting opposing viewpoints to arrive at more thoughtful decisions.

2. What are the key elements essential to the implementation of case management? (Select all that apply.)

• A. Collaborative practice teams
• B. Established critical pathways
• C. Quality management system
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Established critical pathways, collaborative practice teams, and quality management systems are indeed key elements essential to the implementation of case management. Collaborative practice teams allow for multidisciplinary collaboration, established critical pathways help guide patient care, and a quality management system ensures that care provided meets established standards. Choice A, collaborative practice teams, is correct as they are fundamental for effective case management, involving various professionals working together. Choice B, established critical pathways, is also correct as they provide a structured approach to managing patient care. Choice C, quality management system, is correct as it ensures that care is delivered at high standards and continuously monitored for improvement. Therefore, all these elements are crucial for successful case management implementation.

3. Which of the following behaviors would be an early warning sign that you are not handling job stress in a healthy way?

• A. Focusing excessively on patient outcomes
• B. Needing to spend more time alone
• C. Juggling work, studies, and family responsibilities
• D. Awakening in the morning feeling unrested

Correct answer: D

Rationale: The correct answer is D. Awakening in the morning feeling unrested can be an early warning sign that you are not handling job stress in a healthy way. This may indicate that the stress is impacting your quality of sleep, which is essential for managing stress and maintaining overall well-being. Choices A, B, and C are not necessarily indicative of unhealthy stress management. Focusing excessively on patient outcomes may show dedication to work, needing to spend more time alone could be a personal preference, and juggling work, studies, and family responsibilities could be a common challenge that many individuals face.

4. 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.

5. When someone is consistently late for work due to unreliable transportation, this is known as which type of barrier?

• A. Attendance
• B. Voluntary
• C. Motivation
• D. Involuntary

Correct answer: A

Rationale: The correct answer is 'Attendance.' In this scenario, the nurse being late for work due to unreliable transportation is an example of an attendance barrier. This type of barrier refers to factors that affect an individual's ability to be present at work on time, such as transportation issues. Choices B, C, and D are incorrect because voluntary barriers are ones that individuals choose to impose on themselves, motivation barriers relate to lacking the drive to perform a task, and involuntary barriers are obstacles beyond one's control.

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