Nokea
After change-of-shift report, which patient should the nurse assess first?
- A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
- B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
- C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
- D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain
Correct Answer: C
Rationale: The correct answer is C because the patient with hyperosmolar hyperglycemic syndrome showing signs of poor skin turgor and dry oral mucosa is at risk for severe dehydration and potential complications. Assessing this patient first is crucial to address their immediate needs.
Choice A is incorrect as the 19-year-old with possible dawn phenomenon can be assessed after the patient with hyperosmolar hyperglycemic syndrome who is at higher risk.
Choice B is incorrect as a blood glucose reading of 230 mg/dL in a 35-year-old with type 1 diabetes is high but not indicative of an immediate life-threatening situation compared to severe dehydration.
Choice D is incorrect as the 68-year-old with peripheral neuropathy and foot pain, while in discomfort, does not present an immediate threat to their life like severe dehydration does in a patient with hyperosmolar hyperglycemic syndrome.
You may also like to solve these questions
When addressing a policy violation, what is one of the initial steps to take?
- A. Terminate the employee.
- B. Confront the employee.
- C. Discipline the employee immediately.
- D. Determine whether the employee is aware of the policy.
Correct Answer: D
Rationale: The correct answer is D: Determine whether the employee is aware of the policy. This is the initial step to ensure fairness and due process. By confirming the employee's knowledge of the policy, you can address any potential misunderstandings or gaps in communication. Terminating the employee (A) without first verifying their awareness would be hasty and unfair. Confronting the employee (B) may be necessary later, but not as an initial step. Disciplining the employee immediately (C) without understanding their knowledge of the policy could lead to unnecessary conflicts and legal implications. Thus, D is the most appropriate initial step in addressing a policy violation.
Which of the following is an example of a macro-level health policy?
- A. Local health ordinances
- B. State licensing regulations
- C. National healthcare legislation
- D. Institutional policies
Correct Answer: C
Rationale: The correct answer is C: National healthcare legislation. Macro-level health policies are those that are implemented at the national level and have a broad impact on a large population. National healthcare legislation falls under this category as it sets guidelines and regulations for the entire country's healthcare system. Local health ordinances (A) are specific regulations for a particular locality, state licensing regulations (B) are at the state level, and institutional policies (D) are specific to individual healthcare institutions. Therefore, the correct choice is C as it aligns with the definition of macro-level health policy.
What term refers to the situation where the pay of newer employees is similar to or higher than that of more experienced employees?
- A. Salary compression
- B. Salary expectations
- C. Salary range
- D. Salary inflation
Correct Answer: A
Rationale: The correct answer is A: Salary compression. Salary compression occurs when the pay of newer employees is comparable to or higher than that of more experienced employees due to various factors such as market trends, limited salary budgets, or lack of adjustments for inflation. This can lead to decreased morale and motivation among the experienced employees.
Choice B, salary expectations, does not specifically refer to the situation described in the question. Choice C, salary range, is a term used to define the minimum and maximum pay levels for a particular job position and does not address the relationship between newer and more experienced employees' pay. Choice D, salary inflation, refers to the general increase in wages over time due to factors such as rising costs of living and economic growth, but it does not specifically address the scenario of newer employees earning more than experienced employees.
When a client with a terminal diagnosis asks about advance directives, what should the nurse do?
- A. Engage the client and ask why they want to discuss this without their partner present.
- B. Provide information on advance directives and offer brochures.
- C. Advise the client to schedule a discussion with their provider.
- D. Focus on the client's current feelings and postpone planning for a later time.
Correct Answer: A
Rationale: The correct answer is A because it prioritizes client autonomy and respects their wishes. By engaging the client and asking why they want to discuss advance directives without their partner present, the nurse acknowledges the client's right to make decisions about their own healthcare. This approach promotes open communication and allows the client to express their concerns and preferences freely.
Choice B is incorrect as it assumes the client only needs information and brochures without addressing their specific needs or concerns. Choice C is incorrect as it delays addressing the client's immediate questions and concerns about advance directives. Choice D is incorrect as it disregards the client's request to discuss advance directives and focuses solely on their current feelings.
In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?
- A. First
- B. Second
- C. Third
- D. Fourth
Correct Answer: A
Rationale: The correct answer is A, the first step in the grievance process. When a nurse disagrees with a physician's statements, consulting the nurse manager is an initial step to address the issue informally. This step allows for clarification, communication, and resolution at a lower level before escalating to formal grievance procedures. Choices B, C, and D are incorrect because they pertain to subsequent steps in the process after the issue has become more formalized and escalated beyond the initial stage.