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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. Determine the reasons the nurses are not taking scheduled breaks.
- B. Provide coverage for the nurses' breaks.
- C. Review facility policies for taking scheduled breaks.
- D. Discuss time management strategies with the nurses.
Correct Answer: A
Rationale: Determining the reasons for not taking breaks identifies the root cause, enabling targeted solutions to ensure staff well-being.
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A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?
- A. A client who has a raised red skin rash on his arms, neck, and face
- B. A client who has active bleeding from a puncture wound of the left groin area
- C. A client who reports right-sided flank pain and is diaphoretic
- D. A client who reports shortness of breath and left neck and shoulder pain
Correct Answer: B
Rationale: The correct answer is B, a client with active bleeding from a puncture wound of the left groin area. This is the highest priority because active bleeding can lead to severe blood loss, shock, and death if not controlled promptly. Immediate intervention is needed to stop the bleeding, assess for further injuries, and ensure the client's stability. Choices A, C, and D describe concerning symptoms that require attention but do not pose immediate life-threatening risks like uncontrolled bleeding. Therefore, they are of lower priority. It is crucial for the nurse to prioritize clients based on the severity and urgency of their conditions to provide timely and appropriate care.
The family members of an older adult client are expressing conflict over whether the client should have surgery that is recommended by the provider. The oldest adult child has durable power of attorney for health care for the client. The client is oriented to person, place, and time. Which of the following people has the legal authority to make this health care decision?
- A. The client
- B. The partner
- C. The provider
- D. The oldest adult child
Correct Answer: A
Rationale: A mentally competent client retains legal authority to make healthcare decisions, despite a durable power of attorney, which only applies when the client is incapacitated.
A nurse is caring for a client who is having difficulty walking following a stroke. For which of the following members of the interprofessional team should the nurse request a referral?
- A. Occupational therapist
- B. Social worker
- C. Dietitian
- D. Physical therapist
Correct Answer: D
Rationale: The correct answer is D: Physical therapist. The physical therapist specializes in helping individuals regain mobility and strength after a stroke, making them the most appropriate professional to address the client's difficulty walking. They will develop a personalized exercise program to improve balance and coordination. Referring to the other options would not directly address the client's physical mobility issues. Occupational therapists focus on daily living activities, social workers on emotional and social support, and dietitians on nutritional needs, none of which directly address the client's walking difficulty.
A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?
- A. Withhold the benzodiazepine but continue the opioid.
- B. Administer the benzodiazepine but withhold the opioid.
- C. Continue the medication dosages that relieve the client's pain.
- D. Contact the provider about replacing the opioid with an NSAID.
Correct Answer: A
Rationale: The correct answer is A: Withhold the benzodiazepine but continue the opioid. Benzodiazepines can potentiate the sedative effects of opioids, leading to increased somnolence and difficulty arousing the client. By withholding the benzodiazepine, the nurse can help decrease the sedative effects, allowing the client to become more responsive while still receiving pain relief from the opioid. Continuing the opioid ensures that the client's pain is adequately managed. Administering the benzodiazepine alone (choice B) may exacerbate the sedative effects. Continuing the medication dosages (choice C) without adjusting the benzodiazepine dose may not address the sedation issue. Contacting the provider about replacing the opioid with an NSAID (choice D) is not indicated as opioids are typically the mainstay for managing severe pain in terminal illness.
A nurse is providing teaching to a client about advance directive. Which of the following statements by the client indicates an understanding of the teaching?
- A. Once I sign my living will, a family member must co-sign it.
- B. My durable power of attorney for health care is part of my advance directives.
- C. I will wait until I have a serious health problem to sign my advance directives.
- D. My doctor will need to provide approval for the decisions outlined in my living will.
Correct Answer: B
Rationale: The correct answer is B: My durable power of attorney for health care is part of my advance directives. This statement indicates understanding because a durable power of attorney for health care is a legal document that allows an individual to appoint someone to make healthcare decisions on their behalf if they are unable to do so. Advance directives include both living wills and durable powers of attorney for health care. Therefore, acknowledging that the durable power of attorney for health care is part of advance directives demonstrates comprehension of the topic.
Incorrect Answers:
A: Once I sign my living will, a family member must co-sign it - This is incorrect as a living will does not require a family member to co-sign.
C: I will wait until I have a serious health problem to sign my advance directives - This is incorrect as advance directives should be completed before a health crisis occurs.
D: My doctor will need to provide approval for the decisions outlined in my living will - This is incorrect as the decisions in a living will are made