Nokea
A nurse is teaching a class of newly licensed nurses about evidence-based practice. The nurse should include which of the following as the first step in evidence-based practice?
- A. Develop a clinical question.
- B. Collect evidence from a variety of sources.
- C. Apply research to client care practice.
- D. Critically assess the evidence.
Correct Answer: A
Rationale: The correct answer is A: Develop a clinical question. This is the first step in evidence-based practice as it helps focus the search for evidence. By formulating a clear and specific question, nurses can identify relevant research studies to inform their practice. Collecting evidence (B) comes after formulating the question. Applying research to practice (C) and critically assessing evidence (D) are important steps but occur later in the process.
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A nurse is teaching a group of assistive personnel about airborne precautions. Which of the following statements should the nurse make?
- A. Clients who have varicella should be placed in a positive pressure room.
- B. A client who has influenza requires airborne precautions.
- C. An N95 respirator mask is required when caring for a client who has the measles.
- D. Masks are not required when more than 3 ft from a client who requires airborne precautions.
Correct Answer: C
Rationale: An N95 respirator is required for measles, an airborne disease, to protect against droplet nuclei transmission.
The family members of an older adult client are expressing conflict over whether the client should have surgery that is recommended by the provider. The oldest adult child has durable power of attorney for health care for the client. The client is oriented to person, place, and time. Which of the following people has the legal authority to make this health care decision?
- A. The client
- B. The partner
- C. The provider
- D. The oldest adult child
Correct Answer: A
Rationale: A mentally competent client retains legal authority to make healthcare decisions, despite a durable power of attorney, which only applies when the client is incapacitated.
Nurses on an inpatient care unit are working to help reduce unit costs. Which of the following actions is appropriate to include in the cost-containment plan?
- A. Use clean gloves rather than sterile gloves for colostomy care.
- B. Store opened bottles of normal saline in a refrigerator for up to 48 hr.
- C. Return unused supplies from the bedside to the unit's supply stock.
- D. Wait to dispose of sharps containers until they are completely full.
Correct Answer: C
Rationale: The correct answer is C: Return unused supplies from the bedside to the unit's supply stock. This action helps reduce waste by ensuring that supplies are not being unnecessarily discarded. By returning unused supplies, the unit can minimize unnecessary expenditures on restocking items that could have been used if properly managed. Additionally, it promotes efficient resource utilization and cost savings by preventing duplicate purchases.
Incorrect choices:
A: Using clean gloves rather than sterile gloves for colostomy care may compromise patient safety and increase the risk of infection.
B: Storing opened bottles of normal saline in a refrigerator for up to 48 hours may lead to contamination and compromise patient safety.
D: Waiting to dispose of sharps containers until they are completely full may increase the risk of needle-stick injuries and pose safety hazards.
A nurse on a medical surgical unit is caring for a group of clients with the assistance of a licensed practical nurse (LPN) and assistive personnel. Which of the following tasks should the nurse assign to the LPN?
- A. Providing postmortem care for a client who has just died
- B. Reinforcing dietary teaching with a client who has heart disease
- C. Accompanying a client who just had a wound debridement to physical therapy
- D. Obtaining a urine specimen from an older adult client
Correct Answer: D
Rationale: The correct answer is D, assigning the task of obtaining a urine specimen from an older adult client to the LPN. This task falls within the scope of practice for an LPN as it involves basic nursing skills and does not require critical thinking or assessment. LPNs are trained to perform routine procedures such as specimen collection under the supervision of a registered nurse. Providing postmortem care (A) requires emotional support and specialized knowledge beyond the LPN's scope. Reinforcing dietary teaching (B) and accompanying a client to physical therapy (C) involve critical thinking and assessment skills that are typically within the RN's scope. Therefore, D is the correct choice.
A nurse is preparing to discharge a client who has end-stage heart failure. The client's partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take?
- A. Contact the case manager to discuss discharge options.
- B. Request another family member assist the client's partner with care.
- C. Ask the provider to delay the client's discharge home for a few more days.
- D. Recommend the partner place the client in a long-term care facility.
Correct Answer: A
Rationale: A case manager can explore alternative care options, such as home health or facility placement, to support the client and partner.