Nokea
A nurse is performing an end-of-shift count of narcotics kept in the locked cabinet. The narcotic log states there should be 26 oxycodone pills left, but there are only 24 in the drawer. What is the first action of the nurse?
- A. Perform the count again
- B. Contact the pharmacy to determine if the narcotic log is incorrect
- C. Check with the last nurse to sign out narcotics from the system
- D. Notify the house supervisor that narcotic medications are missing
Correct Answer: A
Rationale: The correct answer is A: Perform the count again. The nurse should double-check the count to ensure accuracy before taking further action. Performing the count again helps to rule out any possible errors in the initial count. This step ensures that the discrepancy is not due to a simple mistake or oversight. Contacting the pharmacy (B), checking with the last nurse who signed out narcotics (C), or notifying the house supervisor (D) should be done after confirming the discrepancy through a recount. The first action should always be to verify the count internally before involving external parties or escalating the issue.
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Which of the following may be a cultural barrier that impacts a healthcare provider's ability to provide care or education to the client?
- A. A healthcare provider offers educational materials to a client that are written at an 8th-grade reading level
- B. A Vietnamese woman wants to use steaming in addition to her prescription antibiotics
- C. A healthcare provider uses pantomime to explain a procedure to a deaf client
- D. A Native American client requests a healing ritual before considering surgery
Correct Answer: C
Rationale: The correct answer is C because using pantomime to explain a procedure to a deaf client is a cultural barrier. Deaf individuals may use sign language or have different communication preferences, so relying solely on pantomime may not effectively convey the necessary information. This can lead to misunderstandings or incomplete communication, impacting the quality of care provided.
Choice A is incorrect as offering materials at an 8th-grade reading level is a best practice in health literacy and not a cultural barrier. Choice B may reflect cultural preferences but does not necessarily impede the provider's ability to provide care. Choice D involves a client's spiritual beliefs but does not directly hinder the provider's ability to provide care.
What question must the nurse ask when formulating a nursing diagnosis?
- A. What diagnosis did the physician make for this client?
- B. What is the issue that I can solve for this client?
- C. What physician orders will resolve this issue?
- D. What underlying disease does this client have?
Correct Answer: B
Rationale: The correct answer is B: What is the issue that I can solve for this client? When formulating a nursing diagnosis, the nurse should focus on identifying the client's actual or potential health problems that can be addressed through nursing interventions. This question helps the nurse to pinpoint the specific problem or need that requires nursing attention, leading to the development of an effective care plan.
A: Focusing on the physician's diagnosis is not relevant to formulating a nursing diagnosis.
C: Physician orders are important but not directly related to formulating a nursing diagnosis.
D: Identifying the underlying disease is important but not the primary focus when formulating a nursing diagnosis.
Upon admission to the stroke care unit of a rehabilitation center, what is the primary action of the nurse?
- A. Collect and organize documents for the client's medical record
- B. Prepare the client's identification bracelet
- C. Identify pertinent health history data and current needs and limitations
- D. Gather the client's valuables and secure them in a locked container
Correct Answer: C
Rationale: The correct answer is C because identifying pertinent health history data and current needs and limitations is crucial in developing an individualized care plan for the stroke patient. This data helps determine the appropriate interventions and therapies needed for the client's recovery. Collecting and organizing documents (choice A) can be important but not the primary action. Preparing an identification bracelet (choice B) and gathering valuables (choice D) are important tasks but not the immediate priority upon admission.
At the beginning of her shift in a long-term care facility, which of the following clients should a nurse check on first?
- A. A 91-year-old man who needs help eating breakfast
- B. An 86-year-old man who has been incontinent in his bed
- C. An 82-year-old woman who needs IV antibiotics
- D. A 75-year-old man who is recovering from an injury and needs an ice pack
Correct Answer: C
Rationale: The correct answer is C: An 82-year-old woman who needs IV antibiotics. Checking on this client first is crucial because IV antibiotics are time-sensitive and require proper administration to ensure the effectiveness of treatment. Delaying or missing a dose can have serious consequences for the client's health. The other choices, while important, can be prioritized after attending to the client needing IV antibiotics. A: The 91-year-old man needing help eating breakfast can wait a bit longer. B: The 86-year-old man who has been incontinent can be addressed after the client needing IV antibiotics. D: The 75-year-old man recovering from an injury and needing an ice pack can also be attended to after the client requiring IV antibiotics.
Which of the following is the most appropriate example of anticipatory guidance for a 16-year-old who has been hospitalized for an ankle fracture?
- A. Changes associated with puberty
- B. Driving and staying safe
- C. The health hazards of smoking
- D. Social media influences
Correct Answer: B
Rationale: The correct answer is B: Driving and staying safe. At 16, the teenager is likely preparing to start driving, so guidance on driving safety is crucial. An ankle fracture may impact their ability to drive safely. Other choices lack immediate relevance to the current situation. A: Puberty changes are important but may not be directly related to the hospitalization. C: Smoking hazards, while important, may not be a pressing concern during hospitalization. D: Social media influences, while relevant, are not as critical as driving safety in this scenario.