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A nurse in the emergency department is performing triage for a group of clients who were in a train crash. Which of the following clients should the nurse tag as emergent?
- A. A client who has an open fracture of the femur
- B. A client who has periorbital ecchymosis
- C. A client who has asymmetrical thorax
- D. A client who has a deep-partial thickness burn on the lower extremities
Correct Answer: C
Rationale: In a triage situation, an asymmetrical thorax suggests a potentially life-threatening condition such as a pneumothorax or hemothorax, requiring immediate attention. This client should be tagged as emergent. Periorbital ecchymosis and deep-partial thickness burns, while concerning, may not indicate an immediate life-threatening situation. An open fracture of the femur, although serious, can be prioritized after addressing emergent cases.
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A nurse is assessing an older adult client who was brought to the emergency department by his son, who reports that the client fell at home. The nurse suspects elder abuse. Which of the following actions should the nurse take?
- A. File an incident report.
- B. Ask the client about his injuries with the son present.
- C. Ask the client's son to go to the waiting area.
- D. Treat and discharge the client
Correct Answer: C
Rationale: The correct action for the nurse to take is to ask the client's son to go to the waiting area. This allows the nurse to interview the client independently to assess for signs of elder abuse without the son's potential influence. Filing an incident report may be necessary later but is not the immediate action required. Asking about injuries with the son present could lead to biased responses or intimidation. Treating and discharging the client without addressing the suspicion of elder abuse would neglect the nurse's responsibility to ensure the client's safety.
To resolve a conflict between staff members regarding potential changes in policy, a nurse manager decides to implement the changes she prefers regardless of the feelings of those who oppose those changes. Which of the following conflict-resolution strategies is the nurse manager using?
- A. Competing
- B. Collaborating
- C. Compromising
- D. Cooperating
Correct Answer: A
Rationale: The nurse manager is utilizing the competing conflict-resolution strategy. Competing involves making decisions based on one's preferences without considering the opinions or feelings of others. In this scenario, the nurse manager is unilaterally implementing changes despite opposition, demonstrating a competitive approach. Collaborating involves working together to find a mutually beneficial solution, compromising involves finding a middle ground acceptable to both parties, and cooperating involves working together towards a shared goal. These options are not applicable in this situation as the nurse manager is imposing her preferred changes without regard for others' input.
Ben injects his insulin as prescribed, but then gets busy and forgets to eat. What will the best assessment of the nurse reveal?
- A. The client will be very thirsty.
- B. The client will complain of nausea.
- C. The client will need to urinate.
- D. The client will have moist skin.
Correct Answer: D
Rationale: The correct answer is D. In this scenario, since Ben took his insulin but forgot to eat, he is at risk of developing hypoglycemia. Moist skin is a sign of hypoglycemia, which can occur when blood sugar levels drop too low. Thirstiness (choice A) is more commonly associated with hyperglycemia (high blood sugar levels). Nausea (choice B) and frequent urination (choice C) are not typical immediate signs of hypoglycemia caused by missing a meal after insulin administration.
Why is patient confidentiality significant in healthcare?
- A. Sharing patient information freely
- B. Protecting patient privacy
- C. Ignoring patient consent
- D. Limiting patient access to their own records
Correct Answer: B
Rationale: Patient confidentiality is significant in healthcare because it involves protecting patient privacy. Maintaining confidentiality ensures that patients feel safe and secure when sharing sensitive information with healthcare providers. Choice A is incorrect because sharing patient information freely would violate confidentiality. Choice C is incorrect because ignoring patient consent goes against ethical principles. Choice D is incorrect because limiting patient access to their own records does not relate directly to the concept of patient confidentiality.
Which of the following assessment tools is used to determine the patient's level of consciousness?
- A. The Snellen Scale
- B. The Norton Scale
- C. The Morse Scale
- D. The Glasgow Scale
Correct Answer: D
Rationale: The correct answer is D, The Glasgow Scale. The Glasgow Coma Scale is specifically designed to assess a patient's level of consciousness by evaluating eye opening, verbal response, and motor response. Choices A, B, and C are incorrect because the Snellen Scale is used for vision testing, the Norton Scale is used for assessing the risk of pressure sores, and the Morse Scale is used for evaluating a patient's risk of falling, not for determining the level of consciousness.