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A nurse witnesses a coworker not following facility procedure when discarding the unused portion of a controlled substance. Which of the following actions should the nurse take?
- A. Request that the coworker complete an incident report.
- B. File an anonymous report of the incident to the nurse manager.
- C. Identify all witnesses to the incident.
- D. Document a factual account of the incident.
- E. Submit an incident report to the risk manager.
Correct Answer: B,C,D,E
Rationale: Filing an anonymous report, identifying witnesses, documenting the incident, and submitting a report ensure accountability and prevent recurrence without workplace tension.
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A nurse is participating on a committee that is considering the creation of a policy that will allow nurses to remove chest tubes. Which of the following is an appropriate resource for the nurse to consult in planning for this policy?
- A. State nurse practice act
- B. ANA Standards of Practice
- C. ANA Code of Ethics
- D. Institute of Medicine
Correct Answer: A
Rationale: The correct answer is A: State nurse practice act. The state nurse practice act outlines the scope of practice for nurses within a specific state, including the tasks they can perform. Removing chest tubes is a clinical procedure that falls within the scope of nursing practice. Consulting the state nurse practice act ensures that nurses are adhering to the legal and regulatory standards when performing such procedures.
B: ANA Standards of Practice focuses on the general standards of nursing practice but may not provide specific guidance on chest tube removal.
C: ANA Code of Ethics pertains to ethical principles in nursing and does not provide specific guidelines for clinical procedures like chest tube removal.
D: Institute of Medicine focuses on healthcare quality and safety but does not provide specific guidance on nursing procedures.
Therefore, the state nurse practice act is the most appropriate resource for the nurse to consult in planning for the policy on chest tube removal.
A charge nurse notices that staff nurses are having difficulty using new IV infusion pumps for medication administration. Which of the following is the priority action by the charge nurse?
- A. Assess the staff nurses' knowledge deficit.
- B. Demonstrate use of the pump during medication administration.
- C. Plan an in-service education program on the unit.
- D. Pair an inexperienced nurse with an experienced nurse.
Correct Answer: A
Rationale: The correct answer is A: Assess the staff nurses' knowledge deficit. This is the priority action because it helps identify the root cause of the difficulty with the new IV infusion pumps. By assessing the staff nurses' knowledge deficit, the charge nurse can determine if additional training, education, or support is needed. This step is crucial in addressing the problem effectively and ensuring safe medication administration.
Other choices:
B: Demonstrating the use of the pump during medication administration may be helpful but should come after assessing the knowledge deficit.
C: Planning an in-service education program is important but should be based on the assessment of the staff nurses' knowledge deficit.
D: Pairing an inexperienced nurse with an experienced nurse may be beneficial but does not directly address the underlying issue of knowledge deficit.
A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?
- A. A client who has gestational diabetes and is receiving biweekly nonstress tests
- B. A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor
- C. A client who is at 32 weeks of gestation and has premature rupture of membranes
- D. A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump
Correct Answer: D
Rationale: The correct answer is D because the RN from a medical-surgical unit would have experience managing postoperative care and understanding the complexities of a patient with a PCA pump. Choice A involves monitoring nonstress tests which are more routine and can be handled by other staff. Choice B requires specific knowledge of preeclampsia and labor induction medications. Choice C involves managing premature rupture of membranes which requires obstetrical expertise. Overall, choice D is the most appropriate for the RN who has floated from a medical-surgical unit due to their experience with postoperative care and pain management.
A charge nurse is receiving change-of-shift report. Which of the following situations should the charge nurse address first?
- A. The emergency department nurse is waiting to give report on a new admission.
- B. Two staff members have called to say they will be absent.
- C. A nurse on the previous shift wrote an incident report about a medication error.
- D. Transport assistance is unavailable to take a client to occupational therapy.
Correct Answer: A
Rationale: The correct answer is A because the charge nurse should address urgent situations first. The emergency department nurse waiting to give report on a new admission indicates a critical patient needing immediate attention. Addressing this first ensures timely and appropriate care for the patient. Choices B and D, staff absences and transport assistance availability, can be managed after addressing the urgent patient situation. Choice C, the incident report about a medication error, is important but not as time-sensitive as the new admission report. Therefore, the charge nurse should prioritize addressing the emergency department nurse's report first.
A nurse working on a medical-surgical unit is managing the care of four clients. The nurse should schedule an interdisciplinary conference for which of the following clients?
- A. A client who has orthostatic hypotension and is receiving IV fluids
- B. A client who is receiving heparin and has an aPTT of 34 seconds
- C. A client who has Type 1 diabetes and uses an insulin pump
- D. A client who is at risk for pressure ulcers and has an albumin level of 4.2 g/dL
Correct Answer: D
Rationale: Pressure ulcer risk and nutritional concerns require interdisciplinary collaboration (e.g., dietitian, physical therapist) for comprehensive care.