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A nurse manager is implementing a new electronic health record system. Which of the following actions should the nurse manager take to facilitate staff adoption?
- A. Require staff to use the system without prior training.
- B. Provide hands-on training sessions for all staff members.
- C. Assign super-users to troubleshoot issues during implementation.
- D. Delay the implementation until all staff are comfortable.
Correct Answer: B
Rationale: Providing hands-on training sessions equips staff with the skills and confidence needed to use the new system, facilitating a smooth transition and adoption.
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A nurse on a medical-surgical unit has accepted a transfer to the Intensive care unit (ICU). Prior to transfer to the ICU, the nurse completes an online critical care and emergency nursing course. The nurse is demonstrating which of the following ethical principles?
- A. Nonmaleficence
- B. Veracity
- C. Autonomy
- D. Fidelity
Correct Answer: A
Rationale: The correct answer is A: Nonmaleficence. Nonmaleficence is the ethical principle of doing no harm to patients. By completing a critical care course before transferring to the ICU, the nurse is ensuring that they have the necessary knowledge and skills to provide safe and competent care to critically ill patients, thereby upholding the principle of nonmaleficence. Veracity refers to truthfulness, autonomy to patient's right to make decisions, and fidelity to keeping promises, which are not directly related to the nurse's situation in this scenario.
A nurse is caring for a client who has a history of dementia. The client is alert and oriented to person, place, and time, and has advance directives. The client is scheduled for a procedure that requires informed consent. Which of the following persons should sign the informed consent?
- A. The client
- B. The client's son, who has a durable power of attorney
- C. The client's partner
- D. The client's daughter, who is the primary caregiver
Correct Answer: A
Rationale: The correct answer is A: The client. Informed consent must be given by the client themselves, as they are alert, oriented, and have advance directives. This ensures that the client fully understands the procedure, risks, benefits, and alternatives before giving consent. The client's autonomy and right to make decisions about their own healthcare are paramount. The other choices are incorrect because only the client themselves can provide informed consent in this scenario. The son with durable power of attorney may make decisions when the client is unable to, but since the client is alert and oriented, they should sign the consent. The partner and daughter do not have the authority to provide informed consent on behalf of the client.
A nurse is assigned a group of clients at the start of the shift. Which of the following clients should the nurse plan to care for first?
- A. A client requesting a referral for home health services
- B. A client asking about his PCA pump that contains morphine
- C. A client who needs assistance with a bath
- D. A client who has questions about his new prescription
Correct Answer: B
Rationale: The correct answer is B. The nurse should plan to care for the client asking about his PCA pump with morphine first. This is because the client's inquiry relates to pain management, which is a priority in nursing care. Pain management directly impacts the client's comfort and well-being. Addressing the client's concerns about the PCA pump promptly ensures proper pain relief and prevents potential complications. Clients requesting referrals, assistance with baths, or questions about prescriptions can be attended to after the client with immediate pain management needs is addressed.
A nurse is reviewing admission assessment and plan of care for a client who has Crohn's disease. Admission Assessment
A 20-year-old admitted through emergency department who is experiencing an exacerbation of previously diagnosed Crohn's disease. Client has lost 6.8 kg (15 lb) over the past week and is too nauseated to keep anything down today. They noticed blood in their stool three days ago. Repeatedly stated to staff, "I do not want to live like this. I am totally frustrated with all you medical people."
Assessment:
Right lower quadrant abdominal pain, abdominal bloating, diarrhea (mucus and blood present), perianal abscess.
Vital Signs:
Temperature 37.5° C (99.5° F)
Heart rate 78/min
Respiratory rate 20/min
Blood pressure 102/54 mm/Hg
Provider Prescriptions
Medical management
CBC, CMP. ESR (erythrocyte sedimentary rate)
MRE (magnetic resonance enterography) of pelvis and abdomen
Corticosteroids for clinical finding management. Taper dose as indicated.
Gastrointestinal evaluation
Nutritional screening and management
Screen for depression
Smoking cessation program
Follow CDC recommended immunizations for those on immunosuppressive therapies.
Evaluate for possible surgical management.
A nurse is reviewing admission assessment and plan of care for a client who has Crohn's disease. Which members of the interdisciplinary team should the nurse anticipate being included the plan of care? Select all that apply.
- A. Occupations Therapist
- B. General Surgeon
- C. Physical Therapist
- D. Radiologist
- E. Registered Dietitian
- F. Gastroenterologist
- G. Speech Therapist
Correct Answer: B,D,E,F
Rationale: The correct answer includes a General Surgeon, Radiologist, Registered Dietitian, and Gastroenterologist. General Surgeon is essential for surgical interventions in severe cases. Radiologist helps in diagnostic imaging. Registered Dietitian assists in managing the client's nutritional needs given the impact of Crohn's disease on digestion. Gastroenterologist specializes in treating gastrointestinal issues like Crohn's disease. The other choices are incorrect because: A) Occupational Therapist primarily focuses on helping individuals engage in meaningful activities, which may not be directly related to managing Crohn's disease. C) Physical Therapist focuses on physical rehabilitation, not the primary focus in managing Crohn's disease. G) Speech Therapist is not typically included in the interdisciplinary team for managing Crohn's disease.
A nurse is planning to delegate a task to an assistive personnel (AP). Which of the following actions should the nurse plan to take?
- A. Determine the social skills of the AP.
- B. Assess the AP's ability to follow the client's teaching plan.
- C. Provide a clear description of the task to the AP.
- D. Evaluate the ability of the AP to work with peers.
Correct Answer: C
Rationale: The correct answer is C: Provide a clear description of the task to the AP. This is essential in delegation to ensure the AP understands what is expected. Determining social skills (A) and evaluating ability to work with peers (D) are not directly related to task delegation. Assessing ability to follow a teaching plan (B) is important but not the primary focus in task delegation.