The registered nurse is caring for a client who had a sudden episode of vomiting, which produced 900 mL of frank blood. The nurse directed and delegated to colleagues in order to notify the physician.
The nurse started intravenous fluids and provided physical and emotional support for the client. Which of the following leadership styles did the nurse display in this situation?

Laissez-faire leadership

Autocratic leadership

Democratic leadership

Transformational leadership

Answer and Explanation

The Correct Answer is B

Choice A rationale:
Laissez-faire leadership involves a hands-off approach, where the leader relinquishes much of the decision-making power to the group. This style is less suitable for time-sensitive, high-stakes situations like the one described in the question, where prompt action and clear direction are crucial.
In this case, the nurse took a more proactive and directive role, which is characteristic of autocratic leadership.
While laissez-faire leadership can be effective in certain contexts, it would not have been the most appropriate approach in this particular situation.
Choice B rationale:
Autocratic leadership is characterized by a strong focus on control and centralized decision-making. The leader typically makes decisions independently and expects followers to comply with instructions.
This style can be effective in situations that require quick action and clear direction, such as emergencies or crises. In the scenario presented, the nurse's actions align with autocratic leadership:
The nurse immediately took charge of the situation, directing colleagues to notify the physician and starting intravenous fluids. These actions demonstrate a clear sense of authority and control, which are key elements of autocratic leadership.
While autocratic leadership can sometimes be perceived as overly controlling, it was necessary in this situation to ensure the client's safety and well-being.
Choice C rationale:
Democratic leadership involves a more collaborative approach, where the leader seeks input from followers and encourages participation in decision-making.
This style can be effective in building consensus and fostering teamwork, but it may not be as efficient in situations that require urgent action.
In this case, the nurse did not have time to engage in extensive consultation or discussion. They needed to act quickly and decisively to address the client's needs.
Therefore, democratic leadership would not have been the most appropriate style in this context.
Choice D rationale:
Transformational leadership focuses on inspiring and motivating followers to achieve common goals. Transformational leaders encourage creativity, innovation, and personal growth.
This style can be effective in promoting long-term organizational change and development.
However, in the immediate crisis situation described in the question, the nurse's primary focus was on addressing the client's immediate needs, rather than on fostering long-term change or transformation.
Therefore, transformational leadership would not have been the most suitable style for this particular scenario.

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Correct Answer is D

Explanation

Choice A rationale:
Sterile dressing changes each morning are not directly related to the finding in question. While maintaining sterile dressings is important for postoperative wound care, it's not the primary intervention based on the specific finding you've presented. I'll need more information about the finding to determine the most appropriate rationale for this choice.
Choice B rationale:
Administering pain medications as needed is a common postoperative intervention, but it's not always the most crucial one depending on the patient's condition and the specific finding. It's important to assess the patient's pain level and administer medications accordingly, but pain management shouldn't overshadow other essential interventions.
Choice C rationale:
Conducting a head-to-toe assessment each shift is a comprehensive assessment, but it may not be necessary for every postoperative patient in every situation. The frequency and extent of assessments should be tailored to the patient's individual needs and the specific findings.
Choice D rationale:

Monitoring respirations and breath sounds is often the most critical postoperative intervention, as it allows for early detection of respiratory complications such as pneumonia, atelectasis, or pulmonary embolism. These complications can be life threatening, so prompt identification and intervention are essential.
Specific reasons why monitoring respirations and breath sounds is essential based on the finding (which you haven't provided) could include:
Evidence of respiratory distress or compromise
Changes in breathing patterns or sounds
Decreased oxygen saturation levels
Increased work of breathing
Risk factors for respiratory complications (e.g., type of surgery, underlying lung disease)
I'm ready to provide a more comprehensive rationale for each choice once you share the specific finding that prompted this question.

A. The client should be grateful to be alive. B. This is an abnormal and inappropriate response. C. This is a normal, and appropriate response. D. Tissue healing will help the client to adapt.

Correct Answer is C

Explanation

Choice A rationale:
It is inappropriate and dismissive to tell a client who has experienced a traumatic loss that they should be grateful to be alive. This statement invalidates the client's feelings of grief and loss, and it can hinder the coping process.
It is important for nurses to recognize that grief is a normal and healthy response to loss.
Telling a client to be grateful can imply that their feelings of grief are not valid or that they are not coping appropriately. This can lead to feelings of guilt, shame, and isolation, which can further complicate the grieving process.
Choice B rationale:
It is incorrect to label a client's grief as an abnormal or inappropriate response. Grief is a universal human experience, and there is no right or wrong way to grieve.
Each individual grieves in their own way and at their own pace.
Some people may express their grief openly, while others may grieve more privately.
It is important for nurses to respect the client's individual grieving process and to provide support without judgment. Choice C rationale:
It is important for nurses to recognize that grief is a normal and healthy response to loss.
It is a natural process that allows individuals to come to terms with their loss and to adjust to life without their loved one or without a part of their body.
Experiencing grief does not mean that there is something wrong with the client.
In fact, it is a sign that the client is beginning to process their loss.
Choice D rationale:
While tissue healing is important, it is not the only factor that will help the client to adapt to their loss. The client will also need to address the emotional and psychological aspects of their loss.
This may involve talking about their feelings, seeking support from others, and finding ways to cope with their grief.

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Naxlex Comprehensive Predictor Exams

Based on this finding, which postoperative intervention would be included on the nursing plan of care?

Correct Answer is D

Explanation

A young woman has been in an automobile crash that resulted in an amputation of her left lower leg. She verbalizes grief and loss. What cognitive knowledge by the registered nurse is used to provide interventions to help the client cope?

Correct Answer is C

Explanation

A client tells the registered nurse, “Every time I sneeze, I wet my pants.” What is this type of involuntary escape of urine called?

A mother of a toddler with asthma seeks support from the parents of other children with asthma. The nurse recognizes this as an example of which human dimension?

A registered nurse working in a PACU (post-anesthesia-care-unit) is responsible for conducting assessments on immediate post-operative clients. What is the purpose of these assessments?

A patient is scheduled for an elective hernia repair. The patient has been taking antibiotics for an infection and has experienced episodes of diarrhea while on the antibiotic regimen. What surgical and post-surgical risk should the registered nurse monitor based on this antibiotic use?

A postoperative home care patient has developed thrombophlebitis in her right leg. What type of medication is likely to be prescribed for this cardiovascular complication?

The client has an open wound on the right ankle that the registered nurse has cleansed and dressed with gauze. The nurse now needs to apply a conforming ace bandage to keep the dressing in place. What technique will the nurse use to apply the bandage on the ankle?

Which techniques would the registered nurse identify as regional anesthesia to a patient undergoing surgery? (Select all that apply.)

A registered nurse is attempting to change the method for documenting client care in a medical/surgical floor setting. What questions should be considered before planning change? (Select all that apply.)