Nursing Elites

1. Which of the following is an example of total time lost?

• A. Number of days off that an employee asks for
• B. Number of scheduled days missed
• C. Number of days missed
• D. Number of days perceived to be absent

Correct answer: B

Rationale: The correct answer is B. Total time lost refers to the number of scheduled days that an employee misses. This includes days that were planned to be worked but were not. Choice A, 'Number of days off that an employee asks for,' is not necessarily time lost as these are approved absences. Choice C, 'Number of days missed,' is vague and does not specify if they are scheduled or unscheduled. Choice D, 'Number of days perceived to be absent,' is subjective and does not clearly relate to scheduled time lost.

2. A nurse manager asks the staff to submit written suggestions for a change in policy. The group would then vote on the different suggestions. What type of decision-making technique did the nurse manager use?

• A. Statistical aggregation
• B. Nominal group technique
• C. Brainstorming
• D. Delphi

Correct answer: B

Rationale: The nurse manager used the nominal group technique. This technique involves group members submitting written suggestions, followed by a voting process. Statistical aggregation involves analyzing numerical data, not suggestions. Brainstorming focuses on generating creative ideas collectively, without a structured voting process. Delphi technique involves reaching a consensus through a series of questionnaires or surveys, without a direct voting process.

3. The complexities of the current health care delivery systems require a variety of leadership styles. Which of the following leadership styles would be most effective in this environment?

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

Correct answer: D

Rationale: In complex health care environments, transformational leadership is the most effective style. This leadership approach focuses on inspiring and motivating staff towards a shared vision. Autocratic leadership (choice A) is too controlling and may not foster innovation and adaptability needed in complex systems. Laissez-faire leadership (choice B) lacks guidance and may lead to confusion in intricate healthcare settings. Transactional leadership (choice C) focuses on tasks and rewards, but may not be as effective in promoting innovation and change management required in complex health care delivery systems.

4. What is the role of the Joint Commission in healthcare?

• A. Advocacy for patients
• B. Setting standards for patient care
• C. Providing direct patient care
• D. Approving healthcare facilities

Correct answer: D

Rationale: The correct answer is D: 'Approving healthcare facilities.' The Joint Commission's primary role is to accredit and certify healthcare organizations and programs in the United States. This accreditation ensures that healthcare facilities meet specific quality and safety standards. Choices A, B, and C are incorrect because the Joint Commission focuses on evaluating and accrediting healthcare facilities rather than advocating for patients, providing direct care, or setting standards for patient care.

5. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

• A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
• B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
• C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
• D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

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