A client is receiving pain medication through a PCA pump. Which of the following actions should the nurse take?
- A. Educate the family not to push the button for the client while the client is asleep.
- B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
- C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
- D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.
Correct Answer: D
Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.
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What is a common barrier to effective delegation?
- A. Lack of trust in team members
- B. Lack of communication
- C. Inadequate training
- D. Lack of resources
Correct Answer: A
Rationale: One of the common barriers to effective delegation is a lack of trust in team members. Delegating tasks involves entrusting responsibilities to others, and without trust in the team members' capabilities, the delegator may struggle to effectively assign tasks. Trust is essential for successful delegation as it allows for empowerment and accountability within the team. Lack of communication is also crucial for effective delegation, but the lack of trust has a more profound impact as it directly affects the ability to delegate tasks. Inadequate training and lack of resources, while important factors, are not as fundamental as trust in team members when it comes to effective delegation.
Which regulatory body mandates the provision of immunizations, especially for hepatitis B?
- A. American Nurses Association (ANA)
- B. Occupational Safety and Health Administration (OSHA)
- C. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
- D. State board of nursing
Correct Answer: B
Rationale: The correct answer is B - Occupational Safety and Health Administration (OSHA). OSHA mandates that the hepatitis B vaccine series must be offered to healthcare workers who are not immune to hepatitis. This requirement aims to protect healthcare workers from occupational exposure to bloodborne pathogens, including the hepatitis B virus. The American Nurses Association (ANA) (Choice A) is a professional organization for nurses, not a regulatory body. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) (Choice C) focuses on accrediting healthcare organizations for quality and safety, not mandating immunizations. The State board of nursing (Choice D) is responsible for regulating nursing practice within a specific state, not mandating immunizations.
When facing problems that require immediate action, what organized method involving seven specific steps can nurses use for effective problem-solving?
- A. Nominal group technique
- B. Delphi method
- C. Problem-solving process
- D. Brainstorming
Correct Answer: C
Rationale: The correct answer is C: Problem-solving process. The problem-solving process involving seven specific steps is a structured approach that nurses can utilize when immediate action is required. This method allows for a systematic and organized way of addressing urgent issues, ensuring a thorough and effective problem-solving approach. Choices A, B, and D are incorrect because they do not specifically refer to the structured method involving seven specific steps that nurses can follow for effective problem-solving.
What should the nurse do after a 36-year-old patient treated with intramuscular glucagon for hypoglycemia regains consciousness?
- A. Assess the patient for symptoms of hyperglycemia.
- B. Give the patient a snack of peanut butter and crackers.
- C. Have the patient drink a glass of orange juice or nonfat milk.
- D. Administer a continuous infusion of 5% dextrose for 24 hours.
Correct Answer: B
Rationale: After a patient treated with intramuscular glucagon for hypoglycemia regains consciousness, providing a snack of peanut butter and crackers is essential to prevent another episode of hypoglycemia. Peanut butter and crackers contain a combination of protein and carbohydrates, which can help stabilize the patient's blood glucose levels. This choice is the most appropriate immediate action to prevent recurrence of hypoglycemia in this scenario. Assessing for symptoms of hyperglycemia (choice A) is not the immediate priority after treating hypoglycemia. While orange juice or nonfat milk (choice C) can help raise blood sugar, they lack the sustained effect of protein found in peanut butter. Administering continuous infusion of dextrose (choice D) is excessive and not indicated after the patient has already regained consciousness.
When is the first opportunity for a manager to reduce turnover?
- A. When the decision to hire a new employee is made
- B. After one month of employment
- C. After three months of employment
- D. After a certain tenure period
Correct Answer: C
Rationale: The manager's first opportunity to reduce turnover occurs after three months of employment. During this period, the manager can assess the employee's performance, engagement, and fit within the organization. It allows the manager to address any concerns, provide support, and intervene early to prevent turnover. Waiting until after a certain tenure period might be too late to effectively mitigate turnover risk, as issues could have already escalated. Therefore, the three-month mark is a critical point for managers to proactively manage turnover. Choices A and B are incorrect because they do not allow sufficient time for the manager to evaluate the employee and take proactive measures to reduce turnover. Choice D is incorrect as it is too vague and does not provide a specific actionable timeframe for addressing turnover concerns.