A nurse moves from California to Arkansas and due to having 20 years of experience as a registered nurse is immediately placed in charge of the telemetry unit. The staffing consists of LPNs and two unlicensed assistive personnel. The RN is unsure of the scope of practice of the LPNs and reviews the nurse practice act for Arkansas, which lacks clarity on some tasks. The RN should:
- A. query the state nursing association to determine their stance on the role of LPNs.
- B. ask the LPNs on the unit to list what tasks they routinely performed.
- C. contact the state board of nursing to determine legal scope of practice for LPNs.
- D. refer to California's nurse practice act because the scope of LPNs/LVNs is consistent across the United States.
Correct Answer: C
Rationale: The correct answer is C: contact the state board of nursing to determine legal scope of practice for LPNs. This is the most appropriate action because the state board of nursing is the authoritative body that governs nursing practice within a specific state. By contacting the board, the RN can get accurate and up-to-date information on the legal scope of practice for LPNs in Arkansas. This ensures compliance with state regulations and avoids any potential legal issues.
A: Querying the state nursing association may provide some insight, but the state board of nursing is the official entity that regulates nursing practice.
B: Asking the LPNs about their tasks may not provide a comprehensive understanding of their legal scope of practice and could lead to misunderstandings.
D: Referring to California's nurse practice act is irrelevant as each state has its own regulations, and assuming consistency across states can lead to incorrect assumptions.
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A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be weighed. The physician requests an instrument stat. The nurse turns to hand the instrument to the physician, and the infant falls off the scale. When evaluating the incident, the nurse and her manager list contributory factors such as the need for two nurses when multiple births are known, and the location of the scale so far from the delivery field. These nurses are performing a(n):
- A. standardization of care.
- B. root cause analysis.
- C. process variation.
- D. analysis of a deployment flowchart.
Correct Answer: B
Rationale: The correct answer is B: root cause analysis. Root cause analysis involves identifying the underlying causes of an incident to prevent its recurrence. In this scenario, the nurse and manager are examining factors contributing to the infant falling off the scale. They are looking beyond the immediate event to understand the systemic issues that led to the incident, such as the need for additional staff during multiple births and the placement of the scale far from the delivery field. By conducting a root cause analysis, they aim to address these underlying issues and prevent similar incidents in the future.
A: Standardization of care refers to consistent application of best practices, which is not the focus of the nurse and manager's actions in this situation.
C: Process variation involves analyzing inconsistencies in processes, which is not the primary concern in this incident.
D: Analysis of a deployment flowchart examines the flow of resources in a process, which is not directly related to identifying the root causes of the incident.
A recruiter is explaining benefits to a group of nursing externs who are highly sought for employment. The recruiter states, "We are the only hospital in town that offers a residency program." The recruiter further explains that a residency program:
- A. provides housing for the graduate nurse to decrease expenses until income is established.
- B. partners a medical resident with a nurse resident to learn interprofessional care.
- C. allows new graduates to work on a higher degree in nursing while being paid full-time.
- D. offers extended time for both theory and clinical activities that promote problem solving and clinical decision making.
Correct Answer: D
Rationale: The correct answer is D because a residency program offers extended time for both theory and clinical activities that promote problem-solving and clinical decision-making skills. This is important for new graduates to enhance their clinical skills and transition into practice effectively.
A: Providing housing for the graduate nurse is not typically a component of a residency program.
B: Partnering a medical resident with a nurse resident for interprofessional care is not a defining feature of a nursing residency program.
C: Allowing new graduates to work on a higher degree in nursing while being paid full-time is not the primary focus of a nursing residency program, which is more about developing clinical skills.
Which experience is best designed to support a nursing student's preparation for interprofessional team participation?
- A. Attending a seminar on interprofessional team cooperation
- B. Completing a preceptorship with an advanced practice nurse
- C. Carrying for three patients with varying medical diagnoses
- D. Presenting patient information at the daily care planning meeting on a mental health unit
Correct Answer: B
Rationale: The correct answer is B, completing a preceptorship with an advanced practice nurse. This experience allows the nursing student to directly work with and learn from a more experienced healthcare professional, gaining firsthand knowledge of interprofessional collaboration, communication, and teamwork. The preceptorship provides practical, real-world exposure to interprofessional team dynamics and allows for mentorship and guidance.
A: Attending a seminar may provide theoretical knowledge but lacks the practical application and direct experience of working within a team.
C: Caring for patients with varying medical diagnoses is important for developing clinical skills but may not specifically focus on interprofessional team participation.
D: Presenting patient information at a meeting involves communication skills but does not offer the same level of hands-on experience in interprofessional teamwork as a preceptorship.
What is the primary factor that characterizes a patient receiving palliative care
- A. A diagnosis of a serious, life-threatening disease
- B. Ability to make sound health care decisions
- C. An interest in exploring available life sustaining treatment options
- D. A life expectancy of less than 12 months
Correct Answer: A
Rationale: The correct answer is A because the primary factor that characterizes a patient receiving palliative care is a diagnosis of a serious, life-threatening disease. Palliative care focuses on providing relief from the symptoms and stress of a serious illness, regardless of the stage of the disease or the prognosis. This means that palliative care can be appropriate for patients with a variety of life expectancies, not just those with less than 12 months to live. Choices B and C are incorrect because while they are important factors in healthcare decision-making, they are not the primary factor that characterizes a patient receiving palliative care. Choice D is also incorrect because palliative care can be provided to patients with various life expectancies, not just those with less than 12 months to live.
"A patient with end-stage renal disease has a potassium level of 5 mEq/L. Based on this laboratory result, the nurse interprets which symptom as significant prompting which action?
- A. Drowsiness, stimulate the patient every 30 minutes
- B. Confusion, ask the patient to state their name and date of birth
- C. Irregular heartbeat, evaluate the patient's capillary refill
- D. Muscle cramps, elevate the affected limb"
Correct Answer: C
Rationale: Rationale for Correct Answer C: Irregular heartbeat is a significant symptom of hyperkalemia, which can be life-threatening. The nurse should evaluate capillary refill to assess perfusion. High potassium levels can affect cardiac function, leading to arrhythmias. Monitoring capillary refill provides insight into tissue perfusion, helping to assess the severity of the condition and guide appropriate interventions.
Summary of Incorrect Choices:
A: Drowsiness is not a typical symptom of hyperkalemia. Stimulating the patient every 30 minutes does not address the underlying issue.
B: Confusion is not a common symptom of hyperkalemia. Asking the patient to state their name and birthdate does not address the cardiac implications of high potassium levels.
D: Muscle cramps may occur with hyperkalemia but are not as critical as irregular heartbeat. Elevating the affected limb is not the priority in this situation.