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A nurse is reviewing the laboratory results of a client who is scheduled for surgery. Which of the following results should the nurse report to the provider?
- A. Potassium 3.8 mEq/L
- B. Hemoglobin 7.8 g/dL
- C. Sodium 140 mEq/L
- D. Creatinine 0.9 mg/dL
Correct Answer: B
Rationale: Preoperative lab review identifies risks impacting surgery anemia, electrolytes, or organ function. Hemoglobin 7.8 g/dL below the normal 12-15 g/dL for females or 13-17 g/dL for males indicates anemia, reducing oxygen-carrying capacity, a concern for anesthesia and healing, warranting provider notification for possible transfusion or delay. Potassium 3.8 mEq/L (normal 3.5-5.0), sodium 140 mEq/L (135-145), and creatinine 0.9 mg/dL (0.6-1.2) are within range, posing no immediate threat. Low hemoglobin directly affects surgical safety, triggering urgent communication to adjust the plan, ensuring optimal oxygenation and recovery, a critical nursing responsibility in preoperative care coordination.
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A client with a history of congestive heart failure is prescribed digoxin. Which finding requires immediate intervention?
- A. Heart rate of 55 beats per minute
- B. Blood pressure of 130/80 mmHg
- C. Respiratory rate of 18 breaths per minute
- D. Client reports fatigue
Correct Answer: A
Rationale: With digoxin in CHF, HR 55 needs action, not BP 130/80, RR 18, or fatigue. Digoxin slows HR below 60 risks toxicity, especially with fatigue. Others are stable. Leadership acts imagine dizziness; it prevents arrest, aligning with cardiac care effectively.
The clearly stated goal looks at
- A. What you want
- B. When you want to get it
- C. How will you get it
- D. All the above
Correct Answer: D
Rationale: All what, when, how define goals. Nurse leaders like care plans cover this, contrasting with ambiguity. In healthcare, it's structure, aligning leadership with intent.
The clinic nurse has just accessed a client's chart on the computer. The resident comes over and asks her to stay logged on because he needs to add a note to that client's chart. She should say:
- A. No problem. Just log me off when you're done.'
- B. I'll put the note in for you. What do you want to say?'
- C. Just make sure that you sign your note because it's under my log in ID.'
- D. I'm sorry, but you will have to enter the information using your own log in ID.'
Correct Answer: D
Rationale: Patient privacy and data security are paramount in healthcare, governed by laws like HIPAA. Allowing the resident to use the nurse's login violates these principles, as each provider must use their own credentials to access and modify patient records. This ensures accountability every action is traceable to the individual who performed it and protects the nurse from liability for entries she didn't make. Offering to log off after the resident's use or adding the note herself compromises this accountability, potentially leading to errors or legal issues if the resident's input is inaccurate. Asking the resident to sign the note under her ID still ties her login to his actions, which is insufficient. Requiring the resident to use his own login upholds professional standards, safeguards patient information, and maintains clear responsibility for chart entries.
In Hospital STV, senior administration is strongly oriented toward fiscal and social conservatism. The nursing department is deeply concerned with the provision of quality to the community, which includes a high number of poor and unemployed. To accomplish the goals of the nursing department, resources need to be allocated that administration is not able to allocate. Nursing and administration:
- A. Are engaged in shared governance
- B. Are involved in an irreconcilable conflict of interests
- C. Represent separate subcultures in the institution
- D. Represent union and nonunion conflict
Correct Answer: C
Rationale: Hospital STV's administration and nursing department reflect distinct subcultures administration's fiscal conservatism versus nursing's quality focus for a needy community. Subcultures within organizations have unique values and goals, here creating tension over resource allocation. This isn't shared governance (collaborative decision-making), irreconcilable conflict (not proven unresolvable), or union disputes (no union mentioned). These separate ideologies can coexist, potentially constructively, but currently highlight differing priorities, fitting the subculture concept where groups within an institution operate with distinct, sometimes clashing, perspectives.
A nurse manager is implementing a team nursing approach on his unit, hiring licensed practical nurses (LPNs) and assistive personnel (AP) as additional staff. Which of the following actions should the nurse manager take to facilitate acceptance of this change?
- A. Introduce the new approach and facilitate the development of a task force to plan implementation
- B. Announce the change and expect immediate compliance
- C. Train only the new staff on the approach
- D. Leave the staff to adapt on their own
Correct Answer: A
Rationale: Implementing a team nursing approach requires staff buy-in to ensure smooth adoption and effective collaboration. Introducing the new approach and creating a task force to plan its implementation actively involves the existing staff, giving them a sense of ownership and control over the change process. This strategy fosters acceptance by addressing concerns, encouraging input, and building a collaborative environment, which is critical in healthcare settings where teamwork directly impacts patient outcomes. Simply announcing the change without engagement risks resistance, as staff may feel blindsided or undervalued. Training only new staff excludes current employees, potentially creating resentment or confusion, while leaving staff to adapt independently neglects the need for structured guidance. Involving staff in planning leverages their expertise, reduces anxiety about the unknown, and aligns with leadership principles that prioritize communication and inclusion, ultimately enhancing the transition to a team-based model.