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A nurse manager is addressing a staff nurse's repeated tardiness. Which of the following approaches should the nurse manager use to promote professional accountability?
- A. Assign the nurse extra shifts to make up for lost time.
- B. Discuss the impact of tardiness on client care and team morale.
- C. Document the tardiness as a formal disciplinary action.
- D. Ignore the issue to avoid conflict with the nurse.
Correct Answer: B
Rationale: Discussing the impact of tardiness encourages the nurse to understand the consequences of their actions and take responsibility, promoting professional accountability.
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A nurse is caring for a client who is postoperative following a hip replacement. The client's surgical drain has minimal output. Which of the following actions should the nurse take first?
- A. Notify the provider of the minimal drain output.
- B. Flush the drain with sterile saline.
- C. Document the drain output in the medical record.
- D. Check the drain for kinks or obstructions.
Correct Answer: D
Rationale: Checking the drain for kinks or obstructions is the first step to determine if the minimal output is due to a mechanical issue, which can often be resolved without further intervention.
A nurse is caring for four postoperative clients. The nurse can delegate obtaining vital signs to an assistive personnel (AP) for which of the following clients?
- A. A client who is 3 days postoperative following a craniotomy
- B. A client who is 3 days postoperative following gastric bypass surgery
- C. A client who is 2 hr postoperative following an abdominal hysterectomy
- D. A client who is 1 hr postoperative following a thyroidectomy
Correct Answer: B
Rationale: The correct answer is B because a client who is 3 days postoperative following gastric bypass surgery is stable and unlikely to have immediate complications. Vital signs can be safely delegated to an assistive personnel (AP) for this client.
Choice A is incorrect because a client who is 3 days postoperative following a craniotomy may still be at risk for neurological complications that require close monitoring by a nurse.
Choice C is incorrect because a client who is only 2 hours postoperative following an abdominal hysterectomy is still in the immediate postoperative period and requires frequent monitoring by a nurse.
Choice D is incorrect because a client who is only 1 hour postoperative following a thyroidectomy is in the immediate postoperative period and may have potential complications that require close monitoring by a nurse.
Overall, the key factor in delegating obtaining vital signs to an AP is the stability of the client's condition postoperatively.
An assistive personnel (AP) comes to work with a new set of artificial nails. The nurse takes the AP to a private location to discuss the issue. Which of the following statements by the nurse is appropriate?
- A. I want you to review the facility's policy on personal attire before you begin the shift.
- B. There is a higher risk of infection for our clients associated with artificial nails.
- C. Why would you wear artificial nails to work when you know it's against the rules?
- D. You should know that artificial nails have a very unprofessional appearance.
Correct Answer: B
Rationale: The correct answer is B: There is a higher risk of infection for our clients associated with artificial nails. This statement is appropriate because it directly addresses the potential harm that the AP's artificial nails could pose to clients. Artificial nails can harbor bacteria and increase the risk of transmitting infections in a healthcare setting. It focuses on the importance of infection control and patient safety.
Other choices are incorrect:
A: While reviewing facility policy is important, it does not directly address the issue of infection risk.
C: This statement is accusatory and does not promote a constructive dialogue about infection control.
D: Commenting on appearance is not relevant to the infection risk associated with artificial nails.
A charge nurse is evaluating the performance of an assistive personnel (AP). Which of the following actions by the AP indicates a need for further education?
- A. The AP reports a client's temperature of 38.5°C to the nurse.
- B. The AP assists a client with turning every 2 hours.
- C. The AP leaves a client's meal tray out of reach after delivery.
- D. The AP uses a gait belt when ambulating a client.
Correct Answer: C
Rationale: Leaving the meal tray out of reach prevents the client from eating, indicating a need for further education on client-centered care. The other actions are appropriate.
A home health nurse is planning care for a client who has Alzheimer's disease. The client's partner is her primary caregiver and reports not having enough time to complete his errands. Which of the following referrals should the nurse plan to make?
- A. Respite care
- B. Restorative care
- C. Hospice care
- D. Mental health care
Correct Answer: A
Rationale: The correct answer is A: Respite care. This is the most appropriate referral for the client's partner who needs time off from caregiving responsibilities to complete errands. Respite care provides temporary relief for the primary caregiver, allowing them to take a break while ensuring the client's needs are still met. This helps prevent caregiver burnout and promotes overall well-being for both the caregiver and the client.
Choices B, C, and D are incorrect:
B: Restorative care focuses on restoring the client's functional abilities and independence, which is not directly related to the partner's need for time off.
C: Hospice care is for clients with terminal illnesses who are no longer receiving curative treatment, which is not applicable in this scenario.
D: Mental health care may be beneficial for the client or caregiver in managing emotions and stress, but it does not address the immediate need for respite care.