Nokea
A nurse manager has received information from the facility's risk management department that a former client is pursuing a lawsuit. The nurse manager should anticipate a deposition will be required during which phase of the legal process?
- A. Discovery phase
- B. Decision phase
- C. Trial phase
- D. Complaint phase
Correct Answer: A
Rationale: The correct answer is A: Discovery phase. During the discovery phase of a legal process, both parties exchange information and evidence relevant to the case. A deposition is a part of the discovery phase where witnesses are questioned under oath. In this scenario, the nurse manager would be required to participate in a deposition to provide information related to the lawsuit.
Option B: Decision phase is incorrect as it typically refers to the phase where a judgment or verdict is made. Option C: Trial phase is incorrect as it involves the actual court proceedings. Option D: Complaint phase is incorrect as it is the initial phase where a formal complaint is filed to initiate the legal process.
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A nurse is caring for four clients who are postoperative from surgery 24 hr ago. At 1200 the nurse assesses the clients. Which of the following clients is the nurse's priority?
- A. A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6
- B. A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous
- C. A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL
- D. A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg
Correct Answer: D
Rationale: The correct answer is D. The nurse's priority is the client whose blood pressure dropped significantly from 138/86 mm Hg to 106/60 mm Hg. This indicates a potential issue with perfusion and could be a sign of hypovolemic shock, which is a life-threatening condition requiring immediate intervention to prevent further complications. Monitoring and addressing this client's blood pressure is crucial to prevent deterioration.
Choice A is not the priority because pain management can be addressed after ensuring the client's physiological stability.
Choice B indicates a normal progression in wound healing and does not require immediate attention.
Choice C, while showing an increase in blood glucose levels, does not pose an immediate threat to the client's health compared to a significant drop in blood pressure as in Choice D.
A nurse is triaging clients following a mass casualty event. Which of the following clients should the nurse assess first?
- A. A client who has a small circular partial-thickness burn of the left calf
- B. A client who has a massive head injury and is experiencing seizures
- C. A client who has a splinted open fracture of left medial malleolus
- D. A client who has severe respiratory stridor and a deviated trachea
Correct Answer: D
Rationale: The correct answer is D: A client who has severe respiratory stridor and a deviated trachea. This client should be assessed first because stridor indicates airway obstruction, which can rapidly progress to respiratory failure. A deviated trachea suggests a possible tension pneumothorax, a life-threatening condition requiring immediate intervention to prevent further deterioration. Assessing and managing the airway takes priority over other injuries.
Incorrect choices:
A: A small circular partial-thickness burn of the left calf is a lower priority as it does not pose an immediate threat to life compared to airway compromise.
B: A massive head injury with seizures is serious but managing the airway is the priority in this scenario.
C: A splinted open fracture of the left medial malleolus is important but does not pose an immediate threat to life compared to airway and breathing concerns.
A nurse manager is observing the care provided by a nurse who is in orientation to the unit. Which of the following actions by the nurse indicates the nurse manager should intervene?
- A. The nurse opens the top flap of a sterile tray toward the body when assisting the provider with a thoracentesis.
- B. The nurse uses clean gloves when discontinuing a client's intravenous infusion.
- C. The nurse uses the client's telephone number as one form of identification when administering medications to a client.
- D. The nurse empties a client's drainable colostomy pouch when it is one-third full.
Correct Answer: C
Rationale: The correct answer is C. Using a client's telephone number as identification is a violation of privacy and confidentiality. It is not a secure or reliable form of identification and could lead to errors in medication administration. The other choices do not indicate immediate intervention is needed. A: Opening the top flap of a sterile tray is incorrect but may not cause immediate harm. B: Using clean gloves for discontinuing an IV infusion is incorrect, but can be corrected easily. D: Emptying a colostomy pouch when it is one-third full is appropriate to prevent skin irritation and leakage.
A charge nurse is assigning tasks for a client who is postoperative following a cholecystectomy. Which of the following tasks should the charge nurse delegate to an assistive personnel (AP)?
- A. Assess the client's incisional pain.
- B. Assist the client with ambulation to the bathroom.
- C. Evaluate the client's response to pain medication.
- D. Monitor the client's surgical drain output.
Correct Answer: B
Rationale: Correct Answer: B
Rationale: The charge nurse should delegate assisting the client with ambulation to the bathroom to an assistive personnel (AP) as it is within the AP's scope of practice and does not require specialized nursing knowledge. This task helps promote the client's mobility and independence postoperatively. The AP can provide physical support and ensure the client's safety during ambulation.
Incorrect Choices:
A: Assessing the client's incisional pain requires nursing judgment and assessment skills, which should be done by a licensed nurse.
C: Evaluating the client's response to pain medication involves assessing for effectiveness, side effects, and potential complications, which requires nursing knowledge and assessment skills.
D: Monitoring the client's surgical drain output involves assessing for signs of infection, leakage, or other complications that require nursing judgment and intervention.
A charge nurse is planning to conduct a performance appraisal of a staff member on her unit. Which of the following actions should the nurse take?
- A. Inform the staff member of her appraisal time for that day prior to change-of-shift report.
- B. Schedule the appraisal interview as early in the shift as possible.
- C. Provide the staff member with a copy of the appraisal form in advance.
- D. Provide a chair directly across the desk for the staff member to sit in.
Correct Answer: C
Rationale: The correct answer is C: Provide the staff member with a copy of the appraisal form in advance. This action is essential as it allows the staff member to review the form, prepare their thoughts, and gather any necessary documentation or evidence to support their performance. By providing the form in advance, the staff member can actively participate in the appraisal process and engage in a meaningful discussion during the appraisal interview. This approach promotes transparency, fairness, and constructive feedback.
Other choices are incorrect:
A: Informing the staff member of the appraisal time prior to change-of-shift report may not give them adequate time to prepare for the appraisal.
B: Scheduling the appraisal interview as early in the shift as possible may not allow the staff member enough time to mentally prepare for the appraisal.
D: Providing a chair directly across the desk for the staff member to sit in is a physical setup and does not address the preparation aspect of the performance appraisal.