Nokea
A client has a prescription for valproic acid 250 mg once daily. To maximize the client's safety, which time is best for the nurse to schedule administration of the medication?
- A. With lunch
- B. With breakfast
- C. Before breakfast
- D. At bedtime with a snack
Correct Answer: D
Rationale: Valproic acid is an anticonvulsant that causes central nervous system (CNS) depression. For this reason, the side and adverse effects include sedation, dizziness, ataxia, and confusion. When the client is taking this medication as a single daily dose, administering it at bedtime negates the risk of injury from sedation and enhances client safety. Otherwise, it may be given after meals to avoid gastrointestinal upset.
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Which scenarios demonstrate a participative style of leadership? Select all that apply.
- A. The nurse manager presents a problem to the staff and tells the staff to solve the problem.
- B. The nurse manager arranges unit meetings for all shifts to deal with an identified problem.
- C. The nurse manager assesses a problem and informs the staff of the solution to be implemented.
- D. The nurse manager proposes several methods of dealing with a problem and invites team input.
- E. The nurse manager proposes several solutions to a problem and has the unit staff vote on the best option.
- F. The nurse manager considers staff input related to a problem but makes the final decision on implementation of the solution.
Correct Answer: B,D,F
Rationale: Participative leadership demonstrates an 'in-between' style, neither authoritarian nor democratic. In participative leadership, the manager presents an analysis of problems and proposals for actions to team members, inviting critique and comments. The participative leader then analyzes the comments and makes the final decision. The autocratic style of leadership is task oriented and directive. A laissez-faire leader abdicates leadership and responsibilities, allowing staff to work without assistance, direction, or supervision. The democratic style of leadership involves a majority rule.
The nurse does not intervene when a client becomes hypotensive after surgery. As a result, the client requires emergency surgery to stop postoperative bleeding later that night. The nurse could potentially face which types of prosecution for failing to act? Select all that apply.
- A. Felony
- B. Tort law
- C. Malpractice
- D. Statutory law
- E. Misdemeanor
Correct Answer: B,C
Rationale: Tort law deals with wrongful acts intentionally or unintentionally committed against a person or the person's property. The nurse commits a tort offense by failing to act when the client became hypotensive. Malpractice occurs when a duty to the client is established and the nurse neglects to act responsibly. Options 1 and 5 are offenses under criminal law. Option 4 describes laws enacted by state, federal, or local governments.
The nurse has a prescription to get the client out of bed to a chair on the first postoperative day after total knee replacement surgery. Which action is most appropriate for the nurse to plan to implement to protect the knee joint?
- A. Applying both ice and a compression dressing to the knee while sitting.
- B. Obtaining a walker to minimize weight-bearing by the client on the affected leg.
- C. First applying a knee immobilizer and then elevating the affect leg while sitting.
- D. Lifting the client to the bedside chair, leaving the continuous passive motion (CPM) machine in place.
Correct Answer: C
Rationale: After a total knee replacement, as prescribed, the nurse assists the client to get out of bed on the first postoperative day after putting a knee immobilizer on the affected joint to provide stability. The leg is elevated while the client is sitting in the chair to minimize edema. A compression dressing should already be in place on the wound. Ice is not used unless prescribed. The surgeon prescribes the weight-bearing limits on the affected leg. A CPM machine is used only while the client is in bed and is initiated when prescribed.
When planning the discharge of a client with a diagnosis of chronic anxiety, the nurse develops goals to promote a safe environment at home. Which topic is an appropriate maintenance goal for the client to focus on?
- A. Identifying anxiety-producing situations
- B. Maintaining contact with a crisis counselor
- C. Techniques for ignoring feelings of anxiety
- D. Eliminating all anxiety from daily situations
Correct Answer: A
Rationale: Recognizing situations that produce anxiety allows the client to prepare to cope with anxiety or avoid a specific stimulus. Counselors will not be available for all anxiety-producing situations. Additionally, this option does not encourage the development of internal strengths. Ignoring feelings will not resolve anxiety. It is impossible to eliminate all anxiety from life.
The nurse, after administering an injection to a client, accidentally drops the syringe on the floor. Which nursing action is most appropriate in this situation?
- A. Obtain a dust pan and mop to sweep up the syringe.
- B. Call the housekeeping department to pick up the syringe.
- C. Carefully pick up the syringe from the floor and gently recap the needle.
- D. Carefully pick up the syringe from the floor and dispose of it in a sharps container.
Correct Answer: D
Rationale: Used syringes should always be placed in a sharps container immediately after use to avoid individuals from becoming injured. A syringe should not be swept up because this action poses an additional risk for getting pricked. It is not the responsibility of the housekeeping department to pick up the syringe. Syringes should never be recapped under any circumstances because of the risk of getting pricked with a contaminated needle.