A senior nursing student has been elected president of the Student Nurses Association.
Which of the following qualities is essential to being a nursing leader?

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.

Choice A rationale:
While elevating the head of the bed can make it easier to visualize the patient's face and upper chest, it's not the primary rationale for positioning a patient with pneumonia in semi-Fowler's position.
Skin color and temperature can be assessed in other positions as well, such as supine or side-lying. In cases of pneumonia, prioritizing respiratory function takes precedence over ease of skin assessment. Choice B rationale:
While semi-Fowler's position can offer some comfort, it's not the most comfortable position for all patients, especially those with thoracic pain.
Positions that fully support the back and minimize pressure on the chest, such as side-lying with pillows, may provide better pain relief.
The primary goal in positioning a patient with pneumonia is to optimize respiratory function, not solely to maximize comfort.
Choice C rationale:
Semi-Fowler's position effectively promotes lung expansion due to the following reasons:
Gravity: Elevating the head of the bed allows gravity to assist in pulling the diaphragm downward, creating more space for lung expansion.
Abdominal pressure: The semi-upright position reduces pressure from the abdominal organs on the diaphragm, further facilitating its downward movement and enhancing lung expansion.
Secretion drainage: The inclined position encourages drainage of secretions from the upper airways, preventing their accumulation and potential airway obstruction. This allows for better air entry and gas exchange.
Choice D rationale:
While semi-Fowler's position may slightly increase venous return to the heart, it's not the primary reason for using this position in patients with pneumonia.
Positions that significantly increase venous return, such as Trendelenburg position (head down), are typically used for specific indications like shock or hypotension, not for pneumonia management.