A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the following actions should the nurse take first?
- A. Discuss time management strategies with the nurses
- B. Provide coverage for the nurses' breaks
- C. Determine the reasons the nurses are not taking scheduled breaks
- D. Review policies for taking scheduled breaks
Correct Answer: C
Rationale: The correct answer is to determine the reasons the nurses are not taking scheduled breaks. This action is crucial as it allows the charge nurse to understand the underlying causes for the behavior. By identifying the reasons, the nurse can then address the root of the issue effectively. Option A is incorrect because discussing time management strategies may not address the specific reasons for not taking breaks. Option B is incorrect as providing coverage for breaks does not address the underlying cause of the issue. Option D is also incorrect as reviewing policies should come after understanding the reasons for the behavior.
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A charge nurse is making staff assignments on a medical-surgical unit. Which of the following tasks should the nurse plan to delegate to an assistive personnel?
- A. Measuring oxygen saturation for a client who has dyspnea
- B. Inserting a rectal suppository for a client who is vomiting
- C. Performing nasal hygiene for a client who has an NG tube
- D. Pouching a client's ostomy bag for a new colostomy
Correct Answer: D
Rationale: Pouching a new colostomy is a task that can be safely and appropriately delegated to an assistive personnel as it falls within their scope of practice. Measuring oxygen saturation (Choice A) requires a higher level of training and assessment, making it unsuitable for delegation. Inserting a rectal suppository (Choice B) and performing nasal hygiene (Choice C) involve invasive procedures that are typically performed by licensed nursing staff due to the associated risks and complexities, making them inappropriate for delegation to assistive personnel.
Which of the following is the best argument for lower patient-to-nurse ratio?
- A. The more patients a nurse has, the better the nurse will be at catching early warning signs.
- B. Greater patient-to-nurse ratios decrease patient mortality.
- C. Adequate nurse levels do not impact the prevalence of urinary tract infections.
- D. Community nursing ratios do not impact Methicillin-resistant Staphylococcus aureus (MRSA) rates.
Correct Answer: B
Rationale: The best argument for lower patient-to-nurse ratios is that they decrease patient mortality. Choice A is incorrect because having more patients can lead to increased workload and decreased attention per patient. Choice C is incorrect as adequate nurse levels can indeed impact the prevalence of infections. Choice D is incorrect as community nursing ratios can impact MRSA rates due to potential transmission risks in healthcare settings.
Which patient is exercising their right to autonomy in the context of patient rights?
- A. An 86-year-old female who remains independent in terms of the activities of daily living.
- B. An unemancipated 16-year-old who chooses to not have an intravenous line.
- C. A 32-year-old who does not need the help of the nurse to bathe and groom themselves.
- D. A 99-year-old who wants CPR despite the fact that the nurse and doctor do not think that it would be successful.
Correct Answer: D
Rationale: The correct answer is D. A 99-year-old exercising their right to autonomy in the context of patient rights by choosing CPR. Autonomy in healthcare refers to the patient's right to make their own decisions about their care, even if healthcare providers may disagree. In this scenario, the 99-year-old patient is exercising autonomy by making an informed choice about their medical treatment, despite healthcare professionals having a different opinion. Choices A, B, and C do not directly demonstrate the exercise of autonomy in decision-making regarding medical treatment, making them incorrect.
What is the purpose of a healthcare audit?
- A. To increase paperwork
- B. To assess and improve quality of care
- C. To reduce patient satisfaction
- D. To limit healthcare services
Correct Answer: B
Rationale: The correct answer is B: 'To assess and improve quality of care.' Healthcare audits are conducted to evaluate the quality and efficiency of healthcare services provided. Choice A, 'To increase paperwork,' is incorrect as audits aim to streamline processes and reduce unnecessary paperwork. Choice C, 'To reduce patient satisfaction,' is incorrect as audits are meant to identify areas for improvement to enhance patient satisfaction. Choice D, 'To limit healthcare services,' is also incorrect as audits help in optimizing healthcare services rather than limiting them.
A nurse is assessing an older adult client who was brought to the emergency department by his son, who reports that the client fell at home. The nurse suspects elder abuse. Which of the following actions should the nurse take?
- A. File an incident report.
- B. Ask the client about his injuries with the son present.
- C. Ask the client's son to go to the waiting area.
- D. Treat and discharge the client
Correct Answer: C
Rationale: The correct action for the nurse to take is to ask the client's son to go to the waiting area. This allows the nurse to interview the client independently to assess for signs of elder abuse without the son's potential influence. Filing an incident report may be necessary later but is not the immediate action required. Asking about injuries with the son present could lead to biased responses or intimidation. Treating and discharging the client without addressing the suspicion of elder abuse would neglect the nurse's responsibility to ensure the client's safety.