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A nurse is admitting a client who has an abdominal wound with a large amount of purulent drainage. Which of the following types of transmission precautions should the nurse initiate?
- A. Droplet precautions
- B. Protective environment
- C. Airborne precautions
- D. Contact precautions
Correct Answer: D
Rationale: The correct answer is D: Contact precautions. This is because purulent drainage indicates the presence of infectious material that can easily be transmitted through direct contact. By implementing contact precautions, the nurse can prevent the spread of infection to themselves and others. Droplet precautions (A) are used for pathogens spread through respiratory droplets, protective environment (B) is used for immunocompromised patients, and airborne precautions (C) are used for pathogens that remain suspended in the air. These precautions are not relevant to the situation described with purulent drainage.
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An RN enters a patient’s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?
- A. The RN tells the client he is not allowed to leave until the physician has released him.
- B. The RN asks the client why he wishes to leave.
- C. The RN asks the client to explain what he understands about his medical diagnosis.
- D. The RN asks the client to sign an against medical advice discharge form.
Correct Answer: A
Rationale: The correct answer is A because the RN is restricting the patient's freedom to leave the hospital against his will, which constitutes false imprisonment. The patient has the right to refuse treatment and leave the facility. Choice B is incorrect because asking the client why he wishes to leave shows respect for his autonomy. Choice C is incorrect as it pertains to educating the patient about his medical condition, not restricting his freedom. Choice D is incorrect as asking the client to sign an against medical advice form is a way to document his decision and protect the healthcare provider legally.
Which of the following best describes decertification?
- A. Encourage union affiliation
- B. Change union affiliation
- C. Reward union affiliation
- D. Empower union affiliation
Correct Answer: B
Rationale: The correct answer is B: Change union affiliation. Decertification refers to the process of employees voting to remove a union as their bargaining representative. This means changing or ending their current union affiliation.
A: Encouraging union affiliation is not related to decertification, as it involves promoting rather than changing union membership.
C: Rewarding union affiliation is not accurate for decertification, as it does not involve rewarding but rather changing the affiliation.
D: Empowering union affiliation is not the correct choice, as decertification does not enhance but rather changes or removes union representation.
A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?
- A. Pad the client's wrists before applying the restraints.
- B. Evaluate the client's circulation every 8 hours after application.
- C. Secure the restraint ties to the bed's side rails.
- D. Remove the restraints every 4 hours to evaluate the client's status.
Correct Answer: C
Rationale: The correct answer is C: Secure the restraint ties to the bed's side rails. This is important for ensuring the client's safety and preventing harm. Attaching the restraints to the side rails allows for proper immobilization without causing injury or restricting circulation. Padding the client's wrists (choice A) can be uncomfortable and ineffective. Evaluating circulation every 8 hours (choice B) is not frequent enough for monitoring potential issues. Removing restraints every 4 hours (choice D) can increase the risk of injury and should only be done as necessary.
Which of the following best describes the concept of shared decision-making in healthcare?
- A. The process by which patients make healthcare decisions on their own
- B. A collaborative process that allows patients and providers to make healthcare decisions together
- C. A method for providers to dictate treatment plans to patients
- D. The use of evidence-based guidelines to make healthcare decisions
Correct Answer: B
Rationale: The correct answer is B because shared decision-making in healthcare involves both patients and providers actively participating in the decision-making process together. This collaborative approach allows for a discussion of treatment options, considering patient preferences, values, and medical evidence. It promotes patient autonomy and enhances the quality of care by incorporating both the patient's perspective and the provider's expertise.
Choice A is incorrect because shared decision-making is not solely about patients making healthcare decisions independently. Choice C is incorrect as it describes a paternalistic approach where providers dictate treatment plans to patients, which is not in line with the principles of shared decision-making. Choice D is incorrect as it refers to evidence-based guidelines, which are important but not the sole focus of shared decision-making.
The charge nurse role has negatively affected your relationship with your friends and made you feel tense and isolated. You decide that you will delegate more time-consuming tasks to staff who are not your friends, who then complain to your nurse manager about your perceived unfairness. You decide to:
- A. Talk with your friends individually to let them know that you will be assigning patients to all staff in an equitable manner.
- B. Not express your angry feelings.
- C. Talk about staff who are annoying you with staff on other units.
- D. Ignore your feelings of uncertainty, hoping they will diminish.
Correct Answer: A
Rationale: The correct answer is A because it addresses the issue directly and effectively. By talking individually with your friends and explaining the need for equitable patient assignments, you are promoting fairness and transparency in your delegation process. This approach fosters open communication and helps maintain professional boundaries.
Choice B is incorrect because suppressing your feelings of anger can lead to further tension and unresolved conflicts. Choice C is inappropriate as it involves gossiping about other staff members, which is unprofessional and can create additional problems. Choice D is not a proactive solution and avoiding addressing the issue will only prolong the negative impact on your relationships and work environment.