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A case manager is serving on a community task force on violence in schools. The members of the task force are planning to develop interventions to help prevent violence. According to the nursing process, which is the first activity that the case manager would suggest to the task force?
- A. Teaching schoolchildren about the dangers of school violence
- B. Conducting a community survey to assess community perceptions regarding school violence
- C. Looking at what other communities are doing about school violence
- D. Distributing flyers that identify the causes of school violence to families in the community
Correct Answer: B
Rationale: The correct answer is to conduct a community survey to assess community perceptions regarding school violence. In the nursing process, assessment is always the first step. By conducting a survey, the task force can gather important data about how the community perceives school violence, which is essential for developing effective interventions. Choices A, C, and D involve actions that come after the assessment phase. Teaching schoolchildren about the dangers of violence and distributing flyers are important activities but should come after understanding the community's perceptions and needs. Looking at what other communities are doing is valuable but should also follow a thorough assessment of the specific community's needs and perceptions.
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A case manager is reviewing notations made in clients' records. Which note indicates an unexpected outcome and the need for immediate follow-up?
- A. A client who exhibits signs of increased intracranial pressure after a craniotomy.
- B. A client who has sustained a stroke and dresses herself.
- C. A client with a spinal cord injury transfers himself from a bed to a wheelchair.
- D. Normal neurological findings are noted in a client with a cerebral aneurysm.
Correct Answer: A
Rationale: A case manager is responsible for coordinating a client's care and monitoring for unexpected outcomes. The situation that indicates an unexpected outcome and the need for immediate follow-up is when a client exhibits signs of increased intracranial pressure after a craniotomy. This indicates a deteriorating condition that requires urgent intervention. Choices B, C, and D describe expected outcomes or normal findings related to specific conditions, which do not demand immediate follow-up.
A graduate nurse hired to work in a medical unit of a hospital is attending an orientation session. The nurse educator, discussing care maps, asks the graduate nurse whether she understands how a care map is used. Which response indicates understanding?
- A. The care map outlines the day-to-day expected outcomes of care and the outcomes anticipated at discharge
- B. The care map is a plan that is used only by the nurse to provide client care
- C. The care map is a standard plan, rather than an individualized one, that is developed strictly by a nurse and used for a client with a particular diagnosis
- D. The care map is developed by a nurse and identifies nursing diagnoses
Correct Answer: A
Rationale: The correct answer is A. A care map, also known as a critical pathway, outlines the day-to-day expected outcomes of care and the outcomes anticipated at discharge or the end of a treatment phase. It includes clinical assessments, treatments, dietary interventions, activity therapies, client education, and discharge planning. While it may identify nursing diagnoses, a care map is developed by all disciplines caring for the client type and is used by the interdisciplinary team, not just the nurse alone. Choice B is incorrect because a care map is not solely for the nurse but for the entire interdisciplinary team. Choice C is incorrect as care maps are individualized plans developed by the interdisciplinary team, not just by a nurse. Choice D is incorrect as a care map is not solely about nursing diagnoses but encompasses a comprehensive plan of care.
A health care provider asks the nurse caring for a client with a new colostomy to request the hospital's stoma nurse to visit the client and assist with colostomy care. The nurse initiates the consultation, understanding that the stoma nurse will be able to influence the client because of which type of power?
- A. Expert power
- B. Referent power
- C. Coercive power
- D. Reward power
Correct Answer: A
Rationale: Power is the ability to influence others to achieve goals. Expert power results from knowledge and skills that one possesses that are needed by others. In this scenario, the stoma nurse's expertise in colostomy care gives them the ability to influence the client effectively. Reward power is based on the ability to grant rewards and favors, which is not applicable in this situation. Coercive power is based on fear and the ability to punish, which is not the case in seeking assistance for colostomy care. Referent power results from followers' desire to identify with a powerful person, which is not the primary influence in this context.
A nurse is planning task assignments for the day. Which task should the nurse assign to the nursing assistant?
- A. Suctioning a client who requires periodic suctioning
- B. Assessing a client who has undergone an arteriogram and requires close monitoring
- C. Performing colostomy irrigation on a client with an ostomy
- D. Assisting a client who needs frequent ambulation with a walker
Correct Answer: D
Rationale: When delegating tasks, a nurse must consider the staff member's education and competency level. Noninvasive tasks like helping a client ambulate with a walker are usually suitable for nursing assistants. Suctioning a client and colostomy irrigation are invasive procedures that require a licensed nurse's skills. Assessing a client post-arteriogram for any complications or changes in condition also necessitates the expertise of a licensed nurse. Therefore, the most appropriate task to assign to a nursing assistant is assisting a client who needs frequent ambulation with a walker.
The nurse belongs to a professional nursing organization that provides social, educational, and political venues for nurses. The nurse has been active in this organization for almost two years, during which time she meets and works with nurses from several different nursing agencies and health care institutions to achieve a variety of goals, including obtaining advice regarding a personal career choice. This is an example of:
- A. professional nurturing.
- B. networking.
- C. mentoring.
- D. collegiality.
Correct Answer: B
Rationale: Networking involves the process of developing and using contacts throughout one's professional career for information, advice, and support. In this scenario, the nurse is actively engaging with other professionals from various institutions to achieve common goals and seek career advice, which aligns with the concept of networking. Professional nurturing and mentoring focus on providing support and guidance to colleagues, while collegiality refers to the camaraderie and rapport established among individuals through shared experiences, which is not the primary focus of the nurse's interaction in the given situation.