Nokea
A nurse is listening to a patient's apical heart rate. The patient asks, "Is everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is demonstrating:
- A. open communication.
- B. filtration.
- C. blocking.
- D. false assurance.
Correct Answer: D
Rationale: The correct answer is D: false assurance. By not providing a verbal response to the patient's question and shrugging her shoulders, the nurse is not giving any indication of the patient's actual condition. This lack of communication can lead the patient to interpret the nurse's actions as reassurance that everything is fine, which is a form of false assurance. This behavior can be misleading and may prevent the patient from receiving important information about their health status.
Incorrect choices:
A: open communication - The nurse's lack of verbal response and shrugging shoulders does not demonstrate open communication.
B: filtration - Filtration is not relevant to the situation described.
C: blocking - While the nurse is not providing necessary information, the term "blocking" does not accurately describe the situation.
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The nurse is preparing a plan of care for an black patient who has had a change of bowel habits from being constipated and having only two firm stools weekly to having three or more loose stools daily. Which comment is related to cultural variation for health information?
- A. The individual states, "I will need to discuss health care options with my grandmother."
- B. The eldest male member of the family will make all health care decisions.
- C. The patient has high respect for the nurse and nods approvingly, although she has no intention of complying with instructions or plan of care.
- D. The individual speaks very quietly and gently reaches to hold the nurse's hand for support.
Correct Answer: A
Rationale: The correct answer is A because it reflects the patient's cultural variation in seeking health information from family members, specifically the grandmother. This shows respect for family opinions and involvement in decision-making.
Option B is incorrect as it generalizes that the eldest male makes all health decisions, which may not be true for every cultural group. Option C is incorrect as nodding approvingly and not complying with instructions does not necessarily indicate cultural variations. Option D is incorrect as speaking quietly and reaching for the nurse's hand may simply indicate a patient's communication style rather than cultural variation in seeking health information.
A nurse who was recently certified in chemotherapy administration fails to check compatibility of phenytoin (Dilantin) before injecting into a continuous infusion of D W leading to occlusion of the line. Which statement by the nurse demonstrates a red herring?
- A. The nurse is upset and states, "I am sure I have injected this before without a problem" and the supervisor interprets this to mean the nurse often take shortcuts.
- B. The nurse states, "You are just upset because I am certified in chemotherapy administration and you are not."
- C. "The nurse who started the IV didn't get a blood return but determined the IV was the patient's"that is the problem."
- D. "This drug always occludes the line because it is so viscous."
Correct Answer: D
Rationale: The correct answer is D because it is a red herring statement that distracts from the main issue. Phenytoin is not known to be viscous enough to cause line occlusion. Step 1: Identify the issue - failure to check compatibility. Step 2: A, B, and C address the issue directly or indirectly, while D deflects blame to the drug's viscosity. Step 3: A acknowledges the mistake, B deflects by attacking the supervisor, and C blames the IV setup. In summary, D is incorrect as it diverts attention from the main issue, making it a red herring.
When planning health care, the nurse should be mindful that members of the Asian culture tend to:
- A. miss appointments because they are present oriented and time is viewed as flexible.
- B. look to their ancestors for guidance.
- C. plan ahead and be future oriented.
- D. arrive early because they have no concept of time.
Correct Answer: C
Rationale: The correct answer is C because Asian culture tends to be future-oriented, emphasizing planning and preparation. This is reflected in their approach to health care where they prioritize preventive measures and long-term health goals. Choice A is incorrect as missing appointments is not a common behavior due to cultural time perception. Choice B is incorrect as while ancestors may hold significance, they do not guide health care decisions. Choice D is incorrect as Asians are often punctual and value time.
An older adult client was admitted to the hospital with the condition classified as "pneumonia." Reimbursement was based on a predetermined fixed price. This classification system is referred to as:
- A. diagnosis-related groups (DRGs).
- B. subjective symptom management.
- C. acuity classification system.
- D. organized managed care.
Correct Answer: A
Rationale: The correct answer is A: diagnosis-related groups (DRGs). This classification system assigns a fixed price to specific diagnoses or procedures, such as pneumonia, for reimbursement purposes. DRGs aim to standardize payment based on patient diagnosis and treatment, promoting efficiency and cost containment in healthcare.
B: Subjective symptom management is not a classification system for reimbursement but rather a method of addressing patient symptoms.
C: Acuity classification system refers to determining the level of care a patient needs based on severity, not reimbursement.
D: Organized managed care involves coordination of healthcare services and providers, not specific classification for reimbursement.
A manager just finished the last annual performance review of the staff, reviews the unexpected expenditures for the month due to use of agency nurses, and shares the latest quality indicators with the staff nurses. This manager is performing which management function?
- A. Directing
- B. Planning
- C. Organizing
- D. Controlling
Correct Answer: D
Rationale: The correct answer is D: Controlling. Controlling involves monitoring performance, comparing it to objectives, and taking corrective actions. In this scenario, the manager is reviewing unexpected expenditures and quality indicators to ensure they align with goals and standards. Directing focuses on guiding and motivating employees. Planning involves setting goals and determining actions to achieve them. Organizing involves arranging resources and tasks.