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A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel. What is the best way for the nurse to determine competency of an inexperienced delegatee?
- A. Actually observe the delegatee perform the assigned task.
- B. Ask the delegatee how many times he/she has performed the task.
- C. Ask the patient if the care provided was satisfactory.
- D. Ask other nurses if they feel the delegatee is competent.
Correct Answer: A
Rationale: The correct answer is A. By actually observing the delegatee perform the assigned task, the nurse can directly assess the competency of the delegatee in real-time. This allows the nurse to evaluate the delegatee's skills, knowledge, and adherence to protocols. Asking the delegatee how many times they have performed the task (B) may not accurately reflect their competency level. Asking the patient if the care provided was satisfactory (C) may not provide an objective assessment of the delegatee's competency. Asking other nurses if they feel the delegatee is competent (D) introduces bias and may not reflect the delegatee's actual abilities.
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A nurse is newly employed by a state-owned hospital that provides health care insurance requiring a deductible paid by the employee with the majority of the premium cost covered by the employer. The insurance provided to the nurse is:
- A. private health insurance.
- B. a federal insurances program known as PPACA.
- C. state-subsidized Medicaid insurance.
- D. single-payer system coverage.
Correct Answer: A
Rationale: The correct answer is A: private health insurance. In this scenario, the nurse's insurance is provided by the state-owned hospital, meaning it is not a federal program like PPACA (B) or state-subsidized Medicaid (C). Additionally, it is not a single-payer system (D) since the employer is covering the majority of the premium cost, indicating a private insurance plan. Private health insurance typically involves a deductible paid by the employee, as mentioned in the question. Therefore, the nurse's insurance in this case aligns with the characteristics of private health insurance, making choice A the correct answer.
A new graduate nurse is preparing for an interview for her first position and knows that: (select all that apply)
- A. the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school.
- B. appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position.
- C. self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners.
- D. work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio.
Correct Answer: A
Rationale: The correct answer is A because the primary goal for a new graduate nurse in their first job is to successfully complete the orientation process. This is crucial for transitioning from the academic setting to the professional nursing environment. Completing orientation ensures that the nurse is equipped with the necessary knowledge and skills to provide safe and effective patient care.
Choice B is incorrect because scheduling interviews immediately after graduation may not allow the nurse enough time to prepare adequately for the interview process.
Choice C is incorrect because while self-confidence is important, relying solely on past achievements of peers may not be a sustainable source of confidence in a new work environment.
Choice D is incorrect because while work history and letters of recommendation can be valuable, they may not necessarily be the primary focus during the initial stages of a new nurse's career.
A nurse is charged with battery after helping an invalid patient back to bed and not calling for help due to a reduced staffing level. The patient sustained excessive bruising, sore joints, and extended stay. In this case, the:
- A. patient is the plaintiff.
- B. nurse can be charged with forcefully restraining the patient without orders.
- C. nurse is accountable due to the decreased level of staffing.
- D. charge of invasion of privacy may be withheld.
Correct Answer: C
Rationale: The correct answer is C because the nurse is accountable due to the decreased level of staffing. The nurse's decision not to call for help despite knowing the reduced staffing level directly contributed to the patient's injuries. The nurse had a duty of care to ensure the patient's safety, and failing to do so resulted in harm to the patient. The nurse's actions were negligent and breached the standard of care expected in this situation.
Choices A, B, and D are incorrect because the focus of the question is on the nurse's accountability for the patient's injuries due to staffing levels, not on the patient being the plaintiff, forcefully restraining the patient without orders, or invasion of privacy. These options are not directly related to the nurse's negligence in failing to provide proper care to the patient.
A nurse is asked to "float" to another area where the patients require total care. The nurse smiles, picks up her stethoscope, and says, "I'll come back and eat lunch with everyone here." When she enters the elevator she hits the wall and mutters, "Always me. Don't I have any rights"? The nurse is demonstrating which communication style?
- A. Assertive
- B. Aggressive
- C. Passive
- D. Passive-aggressive
Correct Answer: D
Rationale: The correct answer is D, passive-aggressive. The nurse is indirectly expressing her displeasure and resistance to floating by smiling and agreeing to come back for lunch, but then displaying negative body language and muttering under her breath. This behavior is passive on the surface but aggressive in the underlying tone. The nurse is not openly confronting the issue but is still showing resistance and frustration.
A: Assertive communication involves expressing one's needs and feelings in a direct and respectful manner. The nurse is not openly communicating her feelings or needs in this scenario.
B: Aggressive communication involves expressing needs and feelings in a forceful and hostile manner. The nurse's behavior is not openly hostile towards others.
C: Passive communication involves avoiding conflict and not expressing one's needs or feelings. The nurse is indirectly expressing her displeasure, so it's not purely passive.
An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision?
- A. There is no supervision, because at times the LPN/LVN is not with the RN.
- B. Periodic inspection is being used. Because the LPN/LVN is licensed, the RN is relieved of the need to evaluate care.
- C. Continual supervision is being provided until the RN determines competency.
- D. Initial supervision is being provided because this is the LPN/LVN's first day on the unit.
Correct Answer: C
Rationale: The correct answer is C: Continual supervision is being provided until the RN determines competency.
Rationale:
1. Continual supervision is necessary for the LPN/LVN on the first day to assess their competency.
2. The RN checks frequently throughout the shift to provide support and evaluate the LPN/LVN's performance.
3. Competency must be determined before reducing supervision levels.
4. This level of supervision ensures patient safety and quality care.
Incorrect choices:
A: There is no supervision - Incorrect because supervision is provided by the RN.
B: Periodic inspection - Incorrect as continual supervision is needed for competency assessment.
D: Initial supervision - Incorrect as supervision should continue until competency is established.
In summary, choice C is correct as continual supervision is crucial for the LPN/LVN on their first day to ensure patient safety and quality care.