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A group of nurse managers is asked to engage in a needs assessment for a piece of equipment that will be expensed to the organization's budget. Which question is most important to consider when analyzing the cost-benefit for this piece of equipment?
- A. Can the equipment be updated each year?
- B. How many departments can use this equipment?
- C. Is the cost of equipment reasonable?
- D. Will the equipment require annual repair?
Correct Answer: B
Rationale: The number of departments using the equipment maximizes its benefit and cost-effectiveness across the organization. Updates, cost, and repairs are important but secondary to the equipment's overall utility.
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An adult woman with metastatic pancreatic cancer has requested that no heroic measures are implemented to save her life. Instructions from the healthcare provider have been received to transfer the client to a palliative care room. Which action is most important for the nurse to take first?
- A. Ensure transfer of the client's electronic chart code.
- B. Give a detailed report to the accepting nurse.
- C. Take the family to the client's new room.
- D. Give the client written information about end-of-life care.
Correct Answer: B
Rationale: Giving a detailed report ensures continuity of care, critical for the client's palliative needs. Transferring chart codes, escorting family, or providing written information are secondary to effective handoff.
Several nurses who work on a postoperative surgical unit have reported to the charge nurse their concerns about a particular surgeon's treatment of clients during invasive procedures. Adult clients are often in tears after this particular physician performs central IV line insertions or other invasive procedures. After the charge nurse confronts the healthcare provider who dismisses the concerns, the charge nurse reports the surgeon's behavior to the nurse manager who listens but does nothing about the situation. What action is most important for the charge nurse to take?
- A. Confront the nurse manager as a group and ask why nothing has been done to change the surgeon's behavior.
- B. Attend procedures performed by the surgeon and demand halting the procedure if the client becomes distressed.
- C. Document client reactions to invasive procedures performed by the physician in their medical record.
- D. Report the physician's lack of concern for clients' pain during invasive procedures to the Director of Nursing.
Correct Answer: D
Rationale: Reporting the physician's lack of concern to the Director of Nursing is the most effective action as it escalates the issue to a higher authority with the power to investigate and implement corrective measures, ensuring client safety and welfare. Confronting the nurse manager as a group may create conflict without resolving the issue. Attending procedures and intervening directly could be seen as insubordination and may compromise client safety. Documenting reactions is important but does not address the root cause of the surgeon's behavior.
A client is admitted with shortness of breath and hemoptysis. After several tests, the healthcare provider informs the client that the medical diagnosis is stage 4 breast cancer. The client tells the nurse about the decision not to inform the family about the diagnosis. Which intervention should the nurse implement?
- A. Notify the health department of the client's condition.
- B. Advise the client to weigh all possible outcomes prior to the decision.
- C. Suggest to the family the value of genetic screening.
- D. Explain that the family has a right to know of potential health problems.
Correct Answer: B
Rationale: Advising the client to consider outcomes respects her autonomy while encouraging informed decision-making. Notifying the health department, suggesting screening, or asserting family rights violate confidentiality or autonomy.
A charge nurse is making client assignments in the Intensive Care Department. The healthcare team consists of one nurse with 10 years experience, one nurse with 5 years experience, and a new graduate nurse who just completed a 12-week internship. Which client should the nurse assign to the new graduate nurse?
- A. A client with multisystem failure secondary to a motor vehicle collision.
- B. A client in end-stage liver failure who is experiencing esophageal bleeding.
- C. A client with Adult Respiratory Distress Syndrome who is on a ventilator.
- D. A client with chest tubes secondary to a stab wound to the chest.
Correct Answer: D
Rationale: The client with chest tubes has stable needs manageable by a new graduate with recent training. Multisystem failure, liver failure, and ARDS require advanced skills better suited to experienced nurses.
A staff nurse has been tardy for morning shift assignments for the past three days and provides no explanation for arriving late. Which approach is best for the nurse manager to use when addressing this staff member's tardiness?
- A. Caution the nurse that one more tardiness will result in probational employment.
- B. Offer to switch the nurse's shift assignments to afternoons or evenings.
- C. Stress the expectation that the nurse will arrive on time for all scheduled shifts.
- D. Have the nurse sign a copy of the hospital employee attendance policy.
Correct Answer: C
Rationale: Stressing punctuality expectations communicates the importance of timeliness clearly and respectfully. Threatening probation is overly punitive, changing shifts may not solve the issue, and signing a policy is less effective than direct communication.