Nokea
A charge nurse is planning to conduct a performance appraisal of a staff member on her unit. Which of the following actions should the nurse take?
- A. Inform the staff member of her appraisal time for that day prior to change-of-shift report.
- B. Schedule the appraisal interview as early in the shift as possible.
- C. Provide the staff member with a copy of the appraisal form in advance.
- D. Provide a chair directly across the desk for the staff member to sit in.
Correct Answer: C
Rationale: The correct answer is C: Provide the staff member with a copy of the appraisal form in advance. This action is essential as it allows the staff member to review the form, prepare their thoughts, and gather any necessary documentation or evidence to support their performance. By providing the form in advance, the staff member can actively participate in the appraisal process and engage in a meaningful discussion during the appraisal interview. This approach promotes transparency, fairness, and constructive feedback.
Other choices are incorrect:
A: Informing the staff member of the appraisal time prior to change-of-shift report may not give them adequate time to prepare for the appraisal.
B: Scheduling the appraisal interview as early in the shift as possible may not allow the staff member enough time to mentally prepare for the appraisal.
D: Providing a chair directly across the desk for the staff member to sit in is a physical setup and does not address the preparation aspect of the performance appraisal.
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A nurse on a medical-surgical unit is preparing to contact a provider about a client's condition. The client is 6 hr postoperative from a total hysterectomy. The nurse notes the client's postoperative oxygen saturation is 94% and her apical heart rate is 110. The nurse should include information about the client's oxygen saturation level and heart rate in which component of the SBAR report?
- A. Assessment
- B. Situation
- C. Background
- D. Recommendation
Correct Answer: A
Rationale: Correct Answer: A (Assessment)
Rationale:
1. Assessment in SBAR stands for providing factual data about the client's current condition.
2. Oxygen saturation of 94% and heart rate of 110 are objective data that reflect the client's physiological status.
3. Including this information under Assessment allows the provider to understand the client's current vital signs.
4. Options B, C, and D are incorrect because they do not specifically address the client's physiological data but rather focus on different aspects of the client's situation or background.
A nurse notes a provider frequently arrives to the unit with bloodshot eyes and smells like alcohol after lunch. Which of the following actions should the nurse take?
- A. Inform the state medical board for an immediate investigation.
- B. Counsel the provider to determine the cause of the substance abuse.
- C. Notify the nursing supervisor of the concerns.
- D. Encourage clients to change to a different provider.
Correct Answer: C
Rationale: The correct answer is C: Notify the nursing supervisor of the concerns. This is the most appropriate action because it allows for immediate intervention by someone in authority to address the provider's behavior. The nursing supervisor is in a position to assess the situation, determine the appropriate course of action, and provide support to the nurse in dealing with this sensitive issue. Reporting to the state medical board (choice A) may be premature and could potentially harm the provider's career without first addressing the issue internally. Counseling the provider (choice B) may not be effective if there is a serious substance abuse problem. Encouraging clients to change providers (choice D) is not the nurse's responsibility and may not address the root cause of the issue.
A charge nurse is making assignments for nursing personnel who will be caring for clients during the oncoming shift. Which of the following factors should the charge nurse consider?
- A. The physiologic status of the clients on the unit
- B. Social relationships between nurses working the oncoming shift
- C. Personal comfort level in making the assignments
- D. The most experienced nurse receives the more complex clients
Correct Answer: A
Rationale: The correct answer is A. The charge nurse should consider the physiologic status of the clients on the unit when making assignments to ensure that each client receives appropriate care based on their health condition. This factor is crucial for patient safety and outcomes. Choice B is incorrect as social relationships between nurses should not influence patient assignments. Choice C is incorrect as personal comfort level should not drive assignment decisions, rather patient needs should. Choice D is incorrect as assigning more complex clients based solely on experience may not always be the best approach, as other factors like workload and skill mix should also be considered.
A nurse is caring for a client who is dying. The nurse should incorporate the principle of nonmaleficence into practice by taking which of the following actions?
- A. Withholding a dose of narcotic pain medication when the client has respiratory depression
- B. Discussing advance directives with the client and the client's family
- C. Providing comfort care measures to the client
- D. Allowing the client's family unlimited visitation at the time of death
Correct Answer: A
Rationale: Correct Answer: A
Rationale: Nonmaleficence is the ethical principle of doing no harm. In this scenario, withholding a dose of narcotic pain medication when the client has respiratory depression aligns with this principle as administering the medication could further compromise the client's respiratory status and potentially harm them. By withholding the medication, the nurse is prioritizing the client's safety and well-being.
Summary of Incorrect Choices:
B: Discussing advance directives is important but does not directly relate to nonmaleficence in this context.
C: Providing comfort care measures is essential but does not specifically demonstrate the principle of nonmaleficence.
D: Allowing unlimited visitation may support emotional well-being but does not directly address the principle of nonmaleficence.
A nurse is triaging clients in the emergency department. Which of the following clients should the nurse ask the provider to care for first?
- A. A toddler who has asthma and has a pulse oximetry reading of 95% while receiving oxygen at 2 L/min
- B. An adolescent who has sickle cell disease, reports pain as 7 on a scale of 0 to 10, and requests pain medication
- C. A toddler who has otitis media, a temperature of 39.2 C (102.6° F), and purulent ear discharge
- D. A school-age child who has acute epiglottitis, is drooling, and has an absence of spontaneous cough
Correct Answer: D
Rationale: The correct answer is D. Acute epiglottitis is a medical emergency due to potential airway compromise. The child's drooling and absence of cough indicate a severe obstruction that can rapidly progress to complete airway closure. Immediate intervention is crucial to prevent respiratory distress or arrest. Choices A, B, and C have less urgent conditions that can be managed after ensuring the child with epiglottitis receives prompt care. Choice A, although having asthma, is stable with adequate oxygenation. Choice B, although in pain, can wait briefly for pain medication. Choice C, although having otitis media, does not present immediate life-threatening risk compared to epiglottitis.