Nokea
A nurse caring for a Hispanic child admitted with diarrhea notices the child is wearing red yarn around the wrist. The nurse compliments the child's "jewelry," knowing it is believed to prevent:
- A. mal ojo.
- B. susto.
- C. bilis.
- D. empacho.
Correct Answer: A
Rationale: The correct answer is A: mal ojo. In Hispanic culture, red yarn around the wrist is believed to protect against mal ojo, or "evil eye." This belief stems from the idea that envy or admiration can lead to negative energy being directed at a person, particularly children, causing harm or illness. By complimenting the child's "jewelry," the nurse is acknowledging and respecting the cultural belief in warding off mal ojo.
Summary:
- A: Mal ojo is the correct answer as the red yarn is believed to protect against it.
- B: Susto is a condition related to fright or soul loss, not associated with red yarn.
- C: Bilis refers to bile and is not relevant to the red yarn.
- D: Empacho is a digestive illness, unrelated to the red yarn tradition.
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A nurse learns in orientation that an incident report does not "blame" anyone but concisely documents the events leading up to an occurrence. Which events would warrant completion of an incident report? (select all that apply)
- A. The client is crying and distraught when he learns of a diagnosis of cancer.
- B. An intravenous antibiotic given preoperatively does not infuse because of a faulty pump.
- C. The nurse is unable to carry out orders written by the specialist because of illegibility.
- D. A client falls while in the shower, although she was told not to get up alone.
Correct Answer: B
Rationale: The correct answer is B because it involves a medical error that could potentially harm the patient. An incident report is necessary to document such events for quality improvement and patient safety. Choice A does not involve a preventable adverse event, so it does not require an incident report. Choice C is related to communication issues and can be resolved without an incident report. Choice D involves a patient fall, which is a reportable event, but the client was informed not to get up alone, making it less urgent for an incident report compared to a medication error.
A nurse responsible for staffing a medical-surgical unit must consider: (select all that apply)
- A. the patient census.
- B. physical layout of the unit.
- C. complexity of care required.
- D. educational level of all staff.
Correct Answer: A
Rationale: The correct answer is A: the patient census. This is crucial for determining the appropriate number of staff needed to provide safe and effective care based on the current number of patients. The patient census directly impacts workload and patient acuity levels. Choices B, C, and D are incorrect because although they may be important factors to consider when staffing a medical-surgical unit, they are not as directly related to determining the immediate staffing needs based on the current patient load. The physical layout of the unit, complexity of care required, and educational level of staff are important for overall unit operations and quality of care but do not have the same immediate impact on staffing decisions as the patient census.
A nurse is delegating to the newly hired nursing unlicensed assistive personnel (UAP) the task of assisting with oral hygiene, knowing that this assignment "does not require decisions based on the nursing process." The nurse is correctly using which of the five rights of delegation?
- A. Supervision
- B. Communication
- C. Person
- D. Circumstance
Correct Answer: C
Rationale: Correct Answer: C - Person
Rationale:
- The five rights of delegation are Right Task, Right Circumstances, Right Person, Right Direction/Communication, and Right Supervision.
- In this scenario, choosing the Right Person means delegating tasks to individuals with appropriate skills and abilities, such as UAP assisting with oral hygiene.
- This choice is correct as the nurse is delegating a task that falls within the UAP's scope of practice without requiring nursing process decisions.
The nurse manager determines that four RNs, five LPN/LVNs, and two unlicensed assistive personnel (UAP) are required per shift to meet the needs of the patient population on the unit, according to acuity and census. The nurse manager is concerned with:
- A. assignments.
- B. staffing.
- C. output.
- D. productivity.
Correct Answer: B
Rationale: The correct answer is B: staffing. The nurse manager's concern is related to ensuring adequate numbers of RNs, LPN/LVNs, and UAPs per shift to meet patient needs. Staffing refers to the appropriate allocation of personnel to provide safe and effective care. Assignments (A) are specific tasks given to staff, output (C) is the end result of a process, and productivity (D) is efficiency in completing tasks - these are not the primary focus of the nurse manager's concern in this scenario. Staffing directly addresses the crucial aspect of having the right mix and number of staff members to deliver quality care.
The massage therapist uses kinesthesia, or thinking about how movement is expressed, to correct habits that cause poor posture and limited movement. This type of massage is called:
- A. Alexander technique.
- B. Feldenkrais method.
- C. healing touch.
- D. Reiki.
Correct Answer: B
Rationale: The correct answer is B: Feldenkrais method. This method focuses on improving movement patterns through kinesthetic awareness and re-education. It helps correct habits that lead to poor posture and limited movement by increasing awareness of how the body moves. The Alexander technique (A) mainly focuses on improving posture and reducing tension. Healing touch (C) involves energy-based healing practices, not specifically related to movement correction. Reiki (D) is a form of energy healing that aims to promote relaxation and stress reduction, not movement correction. Therefore, the best choice for the given scenario is the Feldenkrais method.