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A nurse is planning care for several clients. Which of the following clients should the nurse refer to a case manager?
- A. A client who has neurological deficits following a stroke
- B. A client with a minor sprain
- C. A client with a resolved infection
- D. A client needing a one-time dressing change
Correct Answer: A
Rationale: Case managers coordinate complex, long-term care needs, making a client with neurological deficits post-stroke an ideal referral. Strokes often result in ongoing rehabilitation, therapy, and resource needs physical, occupational, or home health requiring sustained planning and cost management beyond acute care. A minor sprain, resolved infection, or one-time dressing change involves short-term, straightforward interventions, manageable by bedside staff without case management's scope. The stroke client's deficits demand interdisciplinary coordination, monitoring, and advocacy, aligning with the case manager's role to optimize recovery, reduce readmissions, and navigate healthcare systems, ensuring comprehensive support for a condition with lasting impact.
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She reads about Path-Goal theory. Which of the following behaviors is manifested by the leader who uses this theory?
- A. Recognizes staff for going beyond expectations by giving them citations
- B. Challenges the staff to take individual accountability for their own practice
- C. Admonishes staff for being laggards
- D. Reminds staff about the sanctions for non-performance
Correct Answer: A
Rationale: Path-Goal theory, per Ms. Caputo's study, involves leaders rewarding exceptional performance like citations to motivate staff toward goals. Challenging accountability aligns with Transformational leadership, admonishing reflects Authoritarian tendencies, and sanctions fit Transactional styles. In a unit, a Path-Goal leader might praise a nurse for swift triage, aligning individual effort with hospital aims. This positive reinforcement clears paths to success, a tactic Ms. Caputo could use to boost morale and productivity, contrasting punitive approaches that might alienate her team in her new managerial role.
A client with a history of hypertension is prescribed lisinopril. Which instruction should the nurse include?
- A. Monitor for a persistent dry cough
- B. Increase intake of potassium-rich foods
- C. Take the medication with meals
- D. Stop the medication if you feel dizzy
Correct Answer: A
Rationale: For lisinopril in HTN, monitor for dry cough, not potassium, meals, or stopping. ACE inhibitors cause cough potassium's risky, food's fine, dizziness needs MD. Leadership teaches this imagine hacking; it ensures awareness, aligning with HTN care effectively.
As a nurse manager, you introduce a program that allows staff to participate in mock drills for emergency preparedness. Your rationale is that mock drills:
- A. Reduce staff accountability
- B. Increase staff confidence in emergencies
- C. Reduce patient safety
- D. Increase managerial control
Correct Answer: B
Rationale: Mock drills boost staff confidence practicing emergencies (e.g., codes) sharpens skills, cutting panic. They don't cut accountability, harm safety, or hike control readiness grows. In your unit, this preps for crises, aligning with safety where trained nurses act decisively, enhancing outcomes and team poise, a proactive step for high-stakes moments.
The old client had to walk along the hall to reach the examination room. During assessment the nurse hears an S4. Which is the best intervention at this moment?
- A. Practice an EKG
- B. Administer nitroglycerin sublingual
- C. Allow rest recumbent for 30 minutes
- D. Call MD immediately
Correct Answer: C
Rationale: An S4 in an elder post-walk suggests diastolic stiffness the nurse allows 30 minutes recumbent rest, not EKG, nitroglycerin, or calling. S4 often reflects aging or exertion, not acute ischemia; rest distinguishes transient from persistent findings. EKG or nitroglycerin assumes angina, and calling escalates prematurely. Leadership opts for this imagine a tired patient; rest clarifies if S4 persists, guiding next steps. This reflects nursing's prudent assessment, ensuring accurate cardiac care in geriatrics effectively.
Which of the following is true about functional nursing?
- A. Concentrates on tasks and activities
- B. Emphasizes the use of group collaboration
- C. One-to-one nurse-patient ratio
- D. Provides continuous, coordinated, and comprehensive nursing services
Correct Answer: A
Rationale: Functional nursing, as Henry's team might assess, focuses on tasks e.g., one nurse medicates, another bathes unlike collaboration (Team), one-to-one (Primary), or comprehensive care (Primary). Efficient for high volumes, it risks missing holistic needs, possibly contributing to low satisfaction in Henry's unit. A nurse might excel at IVs but overlook patient fears, fragmenting care. Leadership here involves weighing this efficiency against patient-centered goals, guiding Henry to adapt systems that balance workload and empathy for better unit outcomes.