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A charge nurse plans to use effective change strategies when implementing a change in a nursing procedure on the medical-surgical unit. Which of the following actions should the charge nurse take during the moving stage of change?
- A. Set a target date.
- B. Use tactics to alert staff nurses that a change is needed.
- C. Evaluate the effectiveness of the change.
- D. Assess the problem.
Correct Answer: A
Rationale: The correct answer is A: Set a target date. During the moving stage of change, setting a target date is crucial to create a sense of urgency and maintain momentum. It provides a clear timeline for implementation, ensuring accountability and focus. This action helps prevent delays and keeps the change process on track.
Choice B is incorrect because alerting staff nurses about the need for change is more relevant during the unfreezing stage. Choice C is incorrect as evaluating effectiveness typically occurs during the refreezing stage. Choice D is incorrect as assessing the problem is part of the initial stages of change management, not the moving stage.
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A nurse is caring for a client who is experiencing chest pain. Which of the following actions should the nurse take first?
- A. Administer prescribed nitroglycerin.
- B. Obtain a 12-lead ECG.
- C. Notify the provider of the chest pain.
- D. Assess the client's pain characteristics.
Correct Answer: D
Rationale: Assessing the client's pain characteristics provides critical data to guide further actions, such as medication administration or diagnostic testing, and is the first step in managing chest pain.
A nurse is caring for a client who is terminally ill and has a do-not-resuscitate (DNR) order. The client's family requests that the nurse withhold pain medication to hasten death. Which of the following responses by the nurse is appropriate?
- A. I'll discuss this with the provider to see what we can do.
- B. Withholding medication to hasten death is not ethical or legal.
- C. Let me get the hospital chaplain to talk with you about this.
- D. I understand your wishes, but I need to follow the client's care plan.
Correct Answer: B
Rationale: Correct Answer: B. Withholding medication to hasten death is not ethical or legal.
Rationale: As a nurse, it is important to uphold ethical principles and follow legal guidelines. Withholding pain medication to hasten death goes against the principle of beneficence, which focuses on doing good for the patient. It also contradicts the principle of nonmaleficence, which emphasizes avoiding harm. Additionally, hastening death through medication is illegal and violates the client's right to receive appropriate care. By choosing this response, the nurse demonstrates ethical integrity and ensures the client's well-being is prioritized.
Summary:
A: Involving the provider is important but does not address the ethical and legal issues at hand.
C: Involving the chaplain may offer emotional support but does not address the ethical dilemma.
D: Following the client's care plan is essential, but in this case, the care plan should not include hastening death.
Overall, response B is the most appropriate as it
A nurse is obtaining informed consent from a client who is preoperative. Which of the following actions should the nurse take? (Select all that apply.)
- A. Verify the client understands the surgical procedure.
- B. Validate the signature is authentic.
- C. Confirm that the consent is voluntary.
- D. Explain the surgical procedure to the client.
- E. Establish that the client is able to pay for the surgical procedure.
Correct Answer: A,B,C
Rationale: Correct Answer: A, B, C
Rationale:
A: Verifying the client understands the surgical procedure ensures they are informed about what will occur during surgery.
B: Validating the signature is authentic confirms the client has personally given consent, enhancing legal protection.
C: Confirming consent is voluntary ensures the client is not coerced or pressured, upholding ethical principles.
Summary:
D: Explaining the surgical procedure is important but not solely the nurse's responsibility for obtaining consent.
E: Ability to pay is not a factor in obtaining informed consent.
Overall, A, B, and C are crucial steps to ensure informed and voluntary consent.
A volunteer assigned to the pediatric unit reports to the charge nurse for an assignment. Which of the following assignments is unsafe for the volunteer?
- A. Transporting a school-age client who is in traction to another department
- B. Reading a book to a preschool client who has AIDS
- C. Rocking an infant who was admitted for croup
- D. Playing a computer video game with an adolescent who has sickle cell disease
Correct Answer: A
Rationale: The correct answer is A because transporting a school-age client in traction requires specialized training to ensure proper handling and safety precautions. Traction devices are delicate and any mishandling could lead to injury. Reading a book to a preschool client with AIDS (B) promotes emotional support. Rocking an infant with croup (C) provides comfort. Playing a computer video game with an adolescent with sickle cell disease (D) promotes social interaction and distracts from pain.
A nurse on the pediatric unit is providing room assignments for children who are to be admitted to the unit. The nurse should plan to place a child who is postoperative from an appendectomy with which of the following clients?
- A. A child who is experiencing sickle cell crisis
- B. A child who has a head injury
- C. A child who has a new diagnosis of type 1 diabetes mellitus
- D. A child who has streptococcal pharyngitis
Correct Answer: C
Rationale: The correct answer is C. Placing the postoperative appendectomy child with a child who has a new diagnosis of type 1 diabetes mellitus is appropriate because both conditions typically require close monitoring but do not pose an immediate risk to each other. The child with appendectomy may need pain management and wound care, while the child with diabetes may need monitoring of blood glucose levels and insulin administration. Placing the postoperative child with a child experiencing sickle cell crisis (A) could be risky due to the potential for infection and stress on both children. Placing the child with a head injury (B) with a postoperative child could be dangerous as the child with a head injury may need a quiet environment and close monitoring for any neurological changes. Placing the child with streptococcal pharyngitis (D) with a postoperative child could increase the risk of infection for the postoperative child.