Nokea
A client with rheumatoid arthritis is prescribed methotrexate. Which laboratory value should the nurse monitor?
- A. White blood cell count
- B. Serum creatinine
- C. Blood glucose
- D. Serum potassium
Correct Answer: A
Rationale: For methotrexate in RA, monitor WBC, not creatinine, glucose, or potassium. This immunosuppressant risks leukopenia infection looms if low. Kidneys matter, but marrow's primary. Leadership watches this imagine fever; it ensures safety, aligning with RA therapy effectively.
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The major focus on self-awareness has been to emphasize the positive aspects that this can have. Self-awareness also has two negative extremes or traps. One of these traps is:
- A. Focusing on oneself can lead to increased self-esteem
- B. Focusing on the self can highlight shortcomings
- C. Focusing on oneself can lead to greater accuracy in evaluating oneself
- D. Focusing on the self can highlight ones strengths
Correct Answer: B
Rationale: Highlighting shortcomings is a trap, unlike esteem, accuracy, or strengths. Nurse leaders like over-criticism avoid this, contrasting with balance. In healthcare, it's constructive, aligning leadership with reflection.
A nurse is assisting with the informed consent process for a client who is scheduled for a below-the-knee amputation. The client asks the nurse, 'Why are they making me have this surgery today? I don't understand why they are doing this.' Which of the following actions should the nurse take?
- A. Explain the procedure in detail
- B. Notify the provider of the client's comments
- C. Reassure the client it's necessary
- D. Have the client sign the consent form
Correct Answer: B
Rationale: Informed consent hinges on the client's full understanding of the procedure, risks, and reasons, which the provider must ensure. When a client expresses confusion, as here with questions about the surgery's necessity, the nurse's role is to facilitate clarity by notifying the provider, who is responsible for explaining and obtaining consent. This action ensures the client receives accurate, authoritative answers, upholding autonomy and legal standards. Explaining the procedure herself exceeds the nurse's scope in this context, risking misinformation. Reassuring without addressing confusion dismisses the client's need for understanding, while forcing a signature without comprehension invalidates consent. Notifying the provider ensures the client's questions are resolved, protecting their rights and ensuring the process remains ethical and informed.
Nonstress test in a 36-week pregnancy is reported as reactive. What does the nurse anticipate should be required?
- A. The test has to be repeated for 20 minutes more
- B. An oxytocin drip will be initiated and the test repeated
- C. Reassurance can be offered
- D. The client has to be prepared for C-section
Correct Answer: C
Rationale: A reactive NST at 36 weeks means reassurance, not repeat testing, oxytocin, or C-section. Fetal heart accelerations show well-being no intervention needed, unlike nonreactive results. Leadership expects this imagine calm parents; it aligns with obstetric care effectively. This reflects nursing's role in fetal monitoring.
The nurse is applying a decision-making process to a clinical challenge. When applying this process, the nurse must:
- A. analyze the root causes of a situation
- B. begin by solving the underlying problem
- C. choose between different courses of action
- D. prioritize the maximum good for the maximum number of people
Correct Answer: C
Rationale: In nursing, decision making involves selecting a course of action, as this nurse must do amidst a clinical challenge. Analyzing root causes or solving problems first are steps within problem solving a systematic subset of decision making but the core act is choosing, like opting for one treatment over another. Prioritizing the maximum good aligns with utilitarian ethics, but nursing often lacks the scope for such broad impact in single decisions. For instance, faced with a patient's deteriorating vitals, the nurse chooses between immediate intervention or monitoring, weighing options based on data and protocols. This choice-driven process, distinct from exhaustive analysis, empowers nurses to act decisively in dynamic settings, ensuring patient safety and care quality, a critical leadership skill in managing clinical uncertainties effectively.
A client with a history of hypertension is prescribed hydrochlorothiazide. Which laboratory value should the nurse monitor?
- A. Potassium
- B. Calcium
- C. Magnesium
- D. Sodium
Correct Answer: A
Rationale: For hydrochlorothiazide in HTN, monitor potassium, not calcium, magnesium, or sodium. Thiazides dump potassium hypokalemia risks arrhythmias. Others shift less. Leadership watches this imagine cramps; it ensures safety, aligning with HTN care effectively.