Nursing Elites

1. What is a common barrier to effective delegation?

• A. Lack of trust in team members
• B. Lack of communication
• C. Inadequate training
• D. Lack of resources

Correct answer: A

Rationale: One of the common barriers to effective delegation is a lack of trust in team members. Delegating tasks involves entrusting responsibilities to others, and without trust in the team members' capabilities, the delegator may struggle to effectively assign tasks. Trust is essential for successful delegation as it allows for empowerment and accountability within the team. While lack of communication is crucial for effective delegation, the lack of trust has a more profound impact as it directly affects the ability to delegate tasks. Inadequate training and lack of resources, although important factors, are not as fundamental as trust in team members when it comes to effective delegation.

2. 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.

3. What is the difference between the amounts that were budgeted for specific revenue or cost and the actual revenue or cost that resulted during the course of activities?

• A. Budget
• B. Variable
• C. Variance
• D. Premiums

Correct answer: C

Rationale: The correct answer is C, Variance. Variance represents the distinction between the planned budgeted amount for a particular revenue or cost and the actual amount that occurred during the activities. In financial management, variance analysis is crucial for assessing performance and identifying areas that deviate from the budgeted expectations. Choice A, 'Budget,' is incorrect as it refers to the planned amount rather than the difference between planned and actual amounts. Choice B, 'Variable,' does not specifically address the comparison between budgeted and actual figures. Choice D, 'Premiums,' is unrelated to the concept of comparing budgeted and actual values in the context of financial analysis.

4. When planning a budget, the nurse manager knows that costs depend on and change in direct proportion to patient volume and activity. What type of costs are these?

• A. Variable costs
• B. Indirect costs
• C. Fixed costs
• D. Direct costs

Correct answer: A

Rationale: Variable costs vary in direct proportion to patient volume and activity. These costs increase or decrease based on the level of patient care provided. Indirect costs are not directly tied to patient volume, fixed costs remain constant regardless of patient volume, and direct costs are directly attributable to patient care but may not vary with patient volume and activity. Therefore, the correct answer is 'Variable costs.'

5. The length of a coaching session should be no longer than:

• A. 15 minutes.
• B. 60 minutes.
• C. 10 minutes.
• D. 30 minutes.

Correct answer: C

Rationale: The correct answer is C: '10 minutes.' Coaching sessions are recommended to last between 5-10 minutes to ensure they are concise and impactful. Choice A ('15 minutes') is incorrect because it exceeds the recommended duration. Choice B ('60 minutes') is incorrect as it is too long for an effective coaching session, leading to decreased engagement. Choice D ('30 minutes') is also incorrect as it surpasses the optimal time frame for a coaching session.

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