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A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?
- A. "I had a bowel movement, but I was able to save the urine."
- B. "I have a specimen in the bathroom from about 30 minutes ago."
- C. "I drink a lot, so I will fill up the bottle and complete the test quickly."
- D. "I flushed what I urinated at 7:00 a.m. and have saved all urine since."
Correct Answer: C
Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.
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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.
Several factors are considered in the calculation of the amount of FTEs. Which of the following is NOT considered when calculating the FTEs? (EXCEPT)
- A. Hours of care provided
- B. Ancillary staff
- C. Procedures to be done
- D. Types of patients
Correct Answer: A
Rationale: When calculating the Full-Time Equivalents (FTEs), factors such as the hours of work for the staff for two weeks, average daily census, and types of patients are considered. However, the hours of care provided are not typically included in the calculation of FTEs. Therefore, the correct answer is A. Choice B, ancillary staff, can impact FTE calculations as they contribute to the overall workload. Choice C, procedures to be done, can also influence FTE calculations, especially if they affect staffing requirements. Choice D, types of patients, play a role in determining the level of care needed and subsequently impact FTE calculations.
When should the nurse initiate discharge planning for a client experiencing an exacerbation of heart failure?
- A. During the admission process
- B. As soon as the client's condition is stable
- C. After consulting with the client's family
- D. During the initial team conference
Correct Answer: B
Rationale: The correct time for the nurse to initiate discharge planning for a client experiencing an exacerbation of heart failure is as soon as the client's condition is stable. Discharge planning should begin early in the admission process to ensure a smooth transition and continuity of care. While involving the client's family in the planning process is crucial, the primary focus should be on starting the preparations for discharge once the client's immediate health concerns are addressed and their condition is stable. Waiting for a team conference or after consulting with the family may delay the planning process, which is not ideal in ensuring a timely and effective discharge plan.
An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN’s friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying?
- A. Fidelity
- B. Confidentiality
- C. Veracity
- D. Accountability
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?
- A. Recency error
- B. Leniency error
- C. Halo error
- D. Absolute judgment
Correct Answer: A
Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.