Nokea
A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?
- A. Pad the client's wrists before applying the restraints.
- B. Evaluate the client's circulation every 8 hours after application.
- C. Secure the restraint ties to the bed's side rails.
- D. Remove the restraints every 4 hours to evaluate the client's status.
Correct Answer: C
Rationale: The correct answer is C: Secure the restraint ties to the bed's side rails. This is important for ensuring the client's safety and preventing harm. Attaching the restraints to the side rails allows for proper immobilization without causing injury or restricting circulation. Padding the client's wrists (choice A) can be uncomfortable and ineffective. Evaluating circulation every 8 hours (choice B) is not frequent enough for monitoring potential issues. Removing restraints every 4 hours (choice D) can increase the risk of injury and should only be done as necessary.
You may also like to solve these questions
A client is discussing the use of herbal supplements for health promotion with a nurse. Which of the following client statements indicates an understanding of herbal supplement use?
- A. I can take echinacea to improve my immune system.
- B. I can take feverfew to reduce my level of anxiety.
- C. I can take ginger to improve my memory.
- D. I can take ginkgo biloba to relieve nausea.
Correct Answer: D
Rationale: The correct answer is D because ginkgo biloba is commonly used to improve memory and cognitive function, not to relieve nausea. Echinacea is known for immune support (A), feverfew for migraine prevention (B), and ginger for nausea relief (C). Understanding the intended use of each herb is crucial for safe and effective supplementation.
Organizations are made up of intertwined links and diversified choices that generate unanticipated consequences. This defines which of the following theories?
- A. Contingency theory
- B. Closed system theory
- C. Open system theory
- D. Chaos theory
Correct Answer: D
Rationale: The correct answer is D: Chaos theory. Chaos theory explains how complex systems, like organizations, can exhibit unpredictable behavior due to small changes in initial conditions. In this context, the interconnectedness and diverse choices within organizations result in unanticipated consequences. Contingency theory (A) focuses on adapting to environmental factors, closed system theory (B) suggests organizations are isolated from the environment, and open system theory (C) emphasizes interactions with the external environment, but none directly address the unpredictable consequences arising from intertwined links and diverse choices within organizations like Chaos theory does.
Which of the following factors may affect successful communication?
- A. Cultural background
- B. Organizational structure
- C. Method of communication
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because all the factors listed - cultural background, organizational structure, and method of communication - can significantly impact successful communication. Cultural background influences language, behavior, and perception. Organizational structure affects the flow of information and decision-making processes. The method of communication, such as verbal, non-verbal, written, or digital, determines how effectively messages are conveyed. By considering and adapting to all these factors, communication can be more successful. The other choices, A, B, and C, are incorrect because each factor individually plays a crucial role in communication effectiveness.
An RN enters a patient’s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?
- A. The RN tells the client he is not allowed to leave until the physician has released him.
- B. The RN asks the client why he wishes to leave.
- C. The RN asks the client to explain what he understands about his medical diagnosis.
- D. The RN asks the client to sign an against medical advice discharge form.
Correct Answer: A
Rationale: The correct answer is A because the RN is restricting the patient's freedom to leave the hospital against his will, which constitutes false imprisonment. The patient has the right to refuse treatment and leave the facility. Choice B is incorrect because asking the client why he wishes to leave shows respect for his autonomy. Choice C is incorrect as it pertains to educating the patient about his medical condition, not restricting his freedom. Choice D is incorrect as asking the client to sign an against medical advice form is a way to document his decision and protect the healthcare provider legally.
There are several pitfalls that should be avoided when using social media of any type. For example, a nurse or student could be found guilty of libel in which of the following scenarios?
- A. Snapping a selfie with a patient
- B. Posting a positive review of the hospital where the student completed clinicals
- C. Creating a closed online forum where students can discuss clinical experiences without providing client information
- D. Complaining about her nurse preceptor on social media, discussing the preceptor’s unprofessional characteristics.
Correct Answer: D
Rationale: The correct answer is D because complaining about a nurse preceptor on social media and discussing their unprofessional characteristics can be considered libel. Libel involves making false and damaging statements about someone that are published and seen by others. This action could harm the preceptor's reputation and potentially lead to legal consequences.
Choice A is incorrect because snapping a selfie with a patient, if done with the patient's consent and in compliance with privacy laws, does not necessarily constitute libel.
Choice B is incorrect because posting a positive review of a hospital is not libelous as long as it is truthful and does not harm anyone's reputation.
Choice C is incorrect because creating a closed online forum for students to discuss clinical experiences without providing client information is a professional and ethical practice that respects privacy and confidentiality.