Nokea
A nurse is planning care for a client who has anorexia nervosa. The nurse should make which of the following client goals the priority?
- A. Encouraging the patient to attend group therapy.
- B. Monitoring for thoughts of self-harm.
- C. Preventing fluid and electrolyte imbalance.
- D. Fostering feelings of self-respect.
Correct Answer: C
Rationale: The correct answer is C: Preventing fluid and electrolyte imbalance. This is the priority goal because individuals with anorexia nervosa are at high risk for dehydration, electrolyte imbalances, and cardiac complications due to severe restriction of food intake. Addressing fluid and electrolyte balance is crucial for the client's physical health and safety. Monitoring for self-harm thoughts (B) and fostering self-respect (D) are important but secondary to the immediate physiological needs of the client. Encouraging group therapy (A) is beneficial for long-term treatment but not as critical as addressing the client's physical health in the immediate term.
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As a nurse manager, you have to be effective in managing a culturally diverse staff. Which of the following nurse manager attributes would assist you in addressing the cultural needs of your staff?
- A. Assuming the thoughts and behaviors of individuals based on their race or ethnicity.
- B. Encouraging the potential in all staff.
- C. Being conscious of the dynamics when culture interacts.
- D. Conducting a cultural self-assessment.
- E. Fostering unity by imposing American values upon all staff members.
Correct Answer: B,C,D
Rationale: Correct Answer: B, C, D
Rationale:
B: Encouraging the potential in all staff is crucial for addressing cultural needs. It promotes inclusivity and values diversity.
C: Being conscious of the dynamics when culture interacts helps in understanding and respecting different cultural perspectives and practices.
D: Conducting a cultural self-assessment is essential to identify biases and gain awareness of one's own cultural background.
Summary:
A: Assuming thoughts and behaviors based on race/ethnicity is stereotyping and can lead to discrimination.
E: Imposing American values may alienate staff with different cultural backgrounds and hinder effective communication and collaboration.
A nurse is a member of a quality-improvement committee seeking to reduce the risk of adverse events in a health care facility. When reviewing recently submitted incident reports, which of the following incidents should the nurse identify as a sentinel event?
- A. Surgery to the wrong site was stopped prior to a procedure.
- B. Paralysis of a client's lower extremities occurred following epidural anesthesia.
- C. A client fall during ambulation did not result in client injury.
- D. A complaint that a nurse was culturally insensitive was made by a client's family member.
Correct Answer: B
Rationale: The correct answer is B: Paralysis of a client's lower extremities occurred following epidural anesthesia. This incident should be identified as a sentinel event because it resulted in a serious harm or death to the patient. Sentinel events are defined as unexpected occurrences involving death or serious physical or psychological injury. In this case, the paralysis of the client's lower extremities following epidural anesthesia qualifies as a serious physical injury. The other choices do not meet the criteria for a sentinel event: A did not result in harm, C did not result in client injury, and D involves a complaint of cultural insensitivity which, while important, does not meet the criteria of a sentinel event.
During a review of back injuries, a unit manager discovers a large number of injuries are occurring in spite of mechanical lifts being used. Furthermore, it is determined that some lifts are outdated. In establishing a quality improvement plan, the unit manager should:
- A. Review the correct procedure with staff members who use the mechanical lifts incorrectly.
- B. Remind employees who sustain back injuries that they are solely responsible for their actions.
- C. Compile Wikipedia articles to develop a revised procedure to operate mechanical lifts.
- D. File a grievance about inadequate funding and an unsafe work environment.
Correct Answer: A
Rationale: The correct answer is A: Review the correct procedure with staff members who use the mechanical lifts incorrectly. This is the correct choice because it addresses the root cause of the problem, which is the incorrect use of mechanical lifts. By reviewing the correct procedure with the staff members, the unit manager can ensure that everyone is properly trained and following the correct protocols, thus reducing the occurrence of back injuries.
Choice B is incorrect because it shifts the blame to the employees instead of addressing the need for proper training and procedures. Choice C is incorrect because using Wikipedia articles may not provide accurate or reliable information for developing a revised procedure. Choice D is incorrect because filing a grievance does not directly address the issue of improper use of mechanical lifts.
During an annual performance evaluation, a manager provides truthful feedback about the nurse's performance. What ethical principle does this represent?
- A. autonomy
- B. nonmaleficence
- C. justice
- D. fidelity
Correct Answer: D
Rationale: The correct answer is D: fidelity. Fidelity refers to the principle of being faithful or loyal to commitments and obligations. In this scenario, the manager providing truthful feedback during the performance evaluation demonstrates fidelity by upholding their professional duty to provide honest and accurate information to support the nurse's growth and development. Autonomy (A) relates to respecting individuals' rights to make their own decisions. Nonmaleficence (B) pertains to avoiding harm. Justice (C) involves fairness and equality in decision-making. In this context, fidelity best aligns with the manager's responsibility to maintain trust and integrity in the feedback process.
A family is keeping vigil at a critically ill patient's bedside. The nurse speaks with the family members and asks if they would benefit from a chaplain visit or resources to aid with grief and coping. What role is the nurse assuming through this action?
- A. Follower
- B. Manager
- C. Laissez-faire
- D. Leader
Correct Answer: D
Rationale: The correct answer is D: Leader. By offering resources and support to the family during a difficult time, the nurse is taking on a leadership role. The nurse is demonstrating initiative, empathy, and guidance in providing options for additional assistance. This action shows the nurse's ability to take charge, make decisions, and support the family in coping with the situation.
A: Follower - Incorrect. The nurse is not following anyone's lead but rather taking charge and offering support.
B: Manager - Incorrect. While the nurse is managing care, the specific action of offering resources and support goes beyond typical managerial duties.
C: Laissez-faire - Incorrect. Laissez-faire implies a hands-off approach, which is not the case here as the nurse is actively engaging with the family.
E, F, G: No options provided.