Nokea
A nurse who was recently certified in chemotherapy administration fails to check compatibility of phenytoin (Dilantin) before injecting into a continuous infusion of D W leading to occlusion of the line. Which statement by the nurse demonstrates a red herring?
- A. The nurse is upset and states, "I am sure I have injected this before without a problem" and the supervisor interprets this to mean the nurse often take shortcuts.
- B. The nurse states, "You are just upset because I am certified in chemotherapy administration and you are not."
- C. "The nurse who started the IV didn't get a blood return but determined the IV was the patient's"that is the problem."
- D. "This drug always occludes the line because it is so viscous."
Correct Answer: D
Rationale: The correct answer is D because it is a red herring statement that distracts from the main issue. Phenytoin is not known to be viscous enough to cause line occlusion. Step 1: Identify the issue - failure to check compatibility. Step 2: A, B, and C address the issue directly or indirectly, while D deflects blame to the drug's viscosity. Step 3: A acknowledges the mistake, B deflects by attacking the supervisor, and C blames the IV setup. In summary, D is incorrect as it diverts attention from the main issue, making it a red herring.
You may also like to solve these questions
A patient is admitted for a hysterectomy, and the RN develops and implements the plan of care but also delegates to the LPN/LVN the responsibility of administering oral medications. While off duty, this RN receives a call requesting a change in the plan of care because the patient has developed deep vein thrombosis. The nurse who originally planned the care is practicing which type of nursing care delivery?
- A. Modular
- B. Primary
- C. Team
- D. Functional
Correct Answer: B
Rationale: The correct answer is B: Primary nursing care delivery. In primary nursing, one nurse assumes 24-hour responsibility for planning, implementing, and evaluating the care of a patient. In this scenario, the RN developed and implemented the plan of care and delegated specific tasks to the LPN/LVN. The RN remains responsible for the overall care even while off duty, as evidenced by receiving a call regarding a change in the plan of care. The other choices are incorrect because:
A: Modular nursing involves a team of healthcare providers working together, sharing responsibilities, and providing care collectively.
C: Team nursing involves a team of healthcare providers with different levels of expertise working collaboratively to deliver patient care.
D: Functional nursing divides tasks among different team members based on their skill sets, which is not the case in the scenario provided.
The use of herbs has become a popular alternative to prescription drugs in today's health care milieu. During which other historical periods did health practices focus on the use of herbs?
- A. Prehistoric times and the Middle Ages
- B. Civil War period and World War I
- C. Renaissance and Reformation periods and the Colonial American period
- D. Crimean War and Civil War periods
Correct Answer: A
Rationale: The correct answer is A: Prehistoric times and the Middle Ages. In prehistoric times, herbs were used as the primary form of medicine. During the Middle Ages, herbal medicine continued to be prevalent due to limited medical knowledge. Other choices are incorrect because B, C, and D do not align with historical periods where herbal medicine was a dominant health practice.
Which nurse is more prone to burnout? The nurse who:
- A. graduated last in the class.
- B. is industrious and conscientious.
- C. refuses to work an extra shift even though he or she needs the money.
- D. volunteers to serve on only one committee and keeps in touch with schoolmates.
Correct Answer: C
Rationale: The correct answer is C because the nurse who refuses to work an extra shift despite needing money is more prone to burnout. This choice indicates a lack of work-life balance and boundary-setting, leading to increased stress and potential burnout. Refusing to take breaks or extra shifts can result in exhaustion and emotional strain.
Option A is incorrect as academic performance does not necessarily correlate with burnout. Option B, being industrious and conscientious, is actually a positive trait that may help prevent burnout through effective time management and self-care. Option D's involvement in one committee and maintaining school connections is also not indicative of burnout risk, as long as boundaries are maintained.
A nurse is charged with battery after helping an invalid patient back to bed and not calling for help due to a reduced staffing level. The patient sustained excessive bruising, sore joints, and extended stay. In this case, the:
- A. patient is the plaintiff.
- B. nurse can be charged with forcefully restraining the patient without orders.
- C. nurse is accountable due to the decreased level of staffing.
- D. charge of invasion of privacy may be withheld.
Correct Answer: C
Rationale: The correct answer is C because the nurse is accountable due to the decreased level of staffing. The nurse's decision not to call for help despite knowing the reduced staffing level directly contributed to the patient's injuries. The nurse had a duty of care to ensure the patient's safety, and failing to do so resulted in harm to the patient. The nurse's actions were negligent and breached the standard of care expected in this situation.
Choices A, B, and D are incorrect because the focus of the question is on the nurse's accountability for the patient's injuries due to staffing levels, not on the patient being the plaintiff, forcefully restraining the patient without orders, or invasion of privacy. These options are not directly related to the nurse's negligence in failing to provide proper care to the patient.
When working with the family of a patient receiving palliative care, what is the nurse's initial intervention?
- A. Determining who will be the patient's durable power of attorney
- B. Identifying what types of help the family will need to care for the patient
- C. Completely an assessment of the family's strengths and weaknesses
- D. Discuss the dynamics of the family with the patient
Correct Answer: B
Rationale: The correct initial intervention for the nurse when working with the family of a patient receiving palliative care is to identify what types of help the family will need to care for the patient (Choice B). This is because understanding the family's needs and resources is essential for providing effective support. By identifying the specific types of assistance required, the nurse can tailor the care plan to meet the family's needs, enhancing the quality of care provided to the patient.
Determining the patient's durable power of attorney (Choice A) is important but usually comes later in the process after understanding the family's needs. Completing an assessment of the family's strengths and weaknesses (Choice C) is valuable but not the initial step. Discussing the dynamics of the family with the patient (Choice D) may be relevant but is not the priority when initiating support for the family.