Nursing Elites

1. Which of the following clients would most likely be selected for case management?

• A. An adolescent with a gunshot wound who is in the ER.
• B. A young adult with a fractured pelvis.
• C. An elderly client awaiting a hip replacement.
• D. A 41-year-old client admitted for outpatient tonsillectomy.

Correct answer: C

Rationale: The correct answer is C, an elderly client awaiting a hip replacement. This choice is most likely selected for case management because hip replacements are common surgical procedures with high volume in hospitals, making it appropriate for case management. Choices A, B, and D involve acute care conditions but do not typically require the same level of coordination and management that a hip replacement case would. Therefore, they are less likely to be selected for case management.

2. The unit manager of a 32-bed medical-surgical unit allows the staff nurses to do self-governance for scheduling, client care assignments, and committee work. The manager would be considered which type of leader?

• A. Autocratic
• B. Democratic
• C. Bureaucratic
• D. Laissez-faire

Correct answer: D

Rationale: The correct answer is D, Laissez-faire. In a laissez-faire leadership style, the manager exerts very little control and allows the staff to have a high degree of autonomy in decision-making and problem-solving. This type of leader provides guidance when needed but largely leaves the decision-making process to the staff. Autocratic leadership (choice A) is characterized by centralizing decision-making authority, democratic leadership (choice B) involves shared decision-making, and bureaucratic leadership (choice C) relies on adherence to rules and procedures.

3. When lifting a bedside cabinet to move it closer to a client, what action should the nurse take to prevent self-injury?

• A. Keep the feet close together.
• B. Use the back muscles for lifting.
• C. Stand close to the cabinet when lifting it.
• D. Bend at the waist.

Correct answer: A

Rationale: The correct answer is A: 'Keep the feet close together.' When lifting a heavy object such as a bedside cabinet, it is essential to maintain a wide base of support by keeping the feet close together. This provides better stability and reduces the risk of injury. Choice B is incorrect because using the back muscles for lifting can lead to back strain and injury; it is recommended to use the legs instead. Choice C is incorrect as standing close to the cabinet may cause the nurse to lose balance and strain the back. Choice D is incorrect because bending at the waist increases the risk of back injury. Therefore, the safest and most appropriate action is to keep the feet close together to ensure stability and prevent self-injury.

4. 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.

5. A healthcare professional is preparing to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the healthcare professional delegate?

• A. Confirming that a client's pain has decreased after receiving an analgesic
• B. Ambulating a client who is postoperative
• C. Inserting an indwelling urinary catheter for a client
• D. Demonstrating the use of an incentive spirometer to a client

Correct answer: A

Rationale: The correct answer is option A: 'Confirming that a client's pain has decreased after receiving an analgesic.' This task involves assessing the effectiveness of the medication, which can be delegated to the assistive personnel. Options B, C, and D involve skills that should be performed by licensed healthcare professionals due to their complexity and potential risks if not done correctly. Ambulating a postoperative client requires monitoring for signs of distress or complications, inserting a urinary catheter involves an invasive procedure with infection risks, and demonstrating the use of medical devices like an incentive spirometer requires specialized knowledge to ensure correct usage.

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