Nokea
A nurse manager is addressing a conflict between a nurse and a client's family member who is upset about visiting hour restrictions. Which of the following statements by the nurse manager is appropriate?
- A. I understand your frustration, and I'll review the visiting policy with you.
- B. You need to follow the hospital rules or leave the premises.
- C. The nurse was just following orders, so please speak to me instead.
- D. Visiting hours are non-negotiable to ensure client safety.
Correct Answer: A
Rationale: Correct Answer: A
Rationale: Option A demonstrates empathy towards the family member's frustration and willingness to address their concerns by reviewing the visiting policy. This approach shows respect and understanding, fostering a positive relationship and potential resolution.
Summary:
B: This response is dismissive and confrontational, not conducive to resolving conflict.
C: Passing blame to the nurse and redirecting the issue does not address the family member's concerns effectively.
D: While prioritizing client safety is important, this response lacks empathy and does not address the family member's feelings.
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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 teaching a group of newly hired nurses about the requirements for disaster planning. Which of the following statements by one of the newly hired nurses indicates an understanding of the teaching?
- A. A staff nurse can function as the incident commander.
- B. An actual disaster cannot take the place of a disaster drill.
- C. A physician must triage victims of a disaster in the emergency department.
- D. Disaster drills should be held on a regular basis.
Correct Answer: D
Rationale: The correct answer is D: Disaster drills should be held on a regular basis. This is essential for preparedness and practice in handling emergencies. Regular drills help ensure staff are familiar with procedures, can identify areas for improvement, and maintain readiness.
Incorrect choices: A: A staff nurse typically does not serve as the incident commander, who is usually a designated leader with specific training. B: While disaster drills are crucial, an actual disaster is unpredictable and serves a different purpose. C: Triage in a disaster is often done by trained personnel such as nurses or paramedics, not just physicians.
A nurse is preparing to administer a prescribed medication to a client. Which of the following actions should the nurse plan to take to demonstrate client advocacy?
- A. Insist the client take prescribed medications.
- B. Inform the client that the medication is the same as taken at home.
- C. Tell the client that refusal of the medication is considered noncompliance.
- D. Encourage the client to verbalize questions.
Correct Answer: D
Rationale: The correct answer is D: Encourage the client to verbalize questions. This demonstrates client advocacy as it empowers the client to actively participate in their care, promotes informed decision-making, and ensures understanding of the medication. This approach respects the client's autonomy and right to make informed choices. It also allows the nurse to address any concerns or misconceptions the client may have, leading to better adherence to the treatment plan.
Incorrect choices:
A: Insisting the client take prescribed medications goes against the principles of client autonomy and informed consent.
B: Simply informing the client about the medication without addressing their questions or concerns does not actively involve the client in their care.
C: Labeling the client's refusal as noncompliance can be seen as judgmental and does not encourage open communication or shared decision-making.
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 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 because a significant drop in blood pressure from 138/86 mm Hg at 0800 to 106/60 mm Hg at 1200 indicates potential hypotension, which could be a sign of hemorrhage or shock postoperatively. Hypotension can lead to inadequate tissue perfusion and organ damage. Monitoring and addressing the client's blood pressure promptly is crucial to prevent further complications.
Choice A is not the priority because an increase in pain from 4 to 6 is significant but does not indicate as immediate risk as hypotension. Choice B, a change in wound drainage consistency, may require monitoring but is not as urgent as addressing hypotension. Choice C, an increase in post-meal blood glucose, is important but does not pose an immediate threat to the client's life compared to hypotension in Choice D.