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A staff nurse has been tardy for morning shift assignments for the past three days and provides no explanation for arriving late. Which approach is best for the nurse manager to use when addressing this staff member's tardiness?
- A. Offer to switch the nurse's shift assignments to afternoons or evenings.
- B. Stress the expectation that the nurse will arrive on time for all scheduled shifts.
- C. Caution the nurse that one more tardiness will result in probational employment.
- D. Have the nurse sign a copy of the hospital employee attendance policy.
Correct Answer: B
Rationale: Stressing the expectation of punctuality clearly communicates standards and promotes accountability.
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The nurse-manager observes that the staff nurse has used wrist restraints to help secure an elderly female in her wheelchair. The client is pleading for the nurse to release her arms. The nurse explains to the nurse-manager that the client needs to be restrained in the wheelchair so that the nurse can change her bed linens. Which is the priority action by the nurse-manager?
- A. Contact the healthcare provider to ensure that a prescription for restraints was written.
- B. Advise the staff nurse to remove the restraints from the client's wrists.
- C. Determine if the client has an as needed (PRN) prescription for an antianxiety agent.
- D. Close the door to the room to avoid disturbing other clients in nearby rooms.
Correct Answer: B
Rationale: Removing restraints prioritizes the client's autonomy and safety, avoiding harm from inappropriate use.
The nurse leading a care team on a medical surgical unit is assigning client care to a practical nurse (PN) and an unlicensed assistive personnel (UAP). Which activity should the nurse assign to the PN?
- A. Evaluate and update plans of care for clients.
- B. Complete comprehensive assessments.
- C. Determine the need for urinary catheterizations.
- D. Measure preoperative clients for elastic stocking size.
Correct Answer: C
Rationale: Determining the need for catheterizations is within the PN's scope, requiring clinical judgment suitable for their training.
A group of nurse managers is asked to engage in a needs assessment for a piece of equipment that will be expensed to the organization's budget. Which question is most important to consider when analyzing the cost-benefit for this piece of equipment?
- A. How many departments can use this equipment?
- B. Can the equipment be updated each year?
- C. Is the cost of equipment reasonable?
- D. Will the equipment require annual repair?
Correct Answer: C
Rationale: Determining if the cost is reasonable directly evaluates the equipment's value against its benefits, critical for budget decisions.
A client is admitted with shortness of breath and hemoptysis. After several tests, the healthcare provider informs the client that the medical diagnosis is stage 4 breast cancer. The client tells the nurse about the decision not to inform the family about the diagnosis. Which intervention should the nurse implement?
- A. Explain that the family has a right to know of potential health problems.
- B. Advise the client to weigh all possible outcomes prior to the decision.
- C. Suggest to the family the value of genetic screening.
- D. Notify the health department of the client's condition.
Correct Answer: B
Rationale: Advising the client to weigh outcomes supports their autonomy while encouraging informed decision-making.
Which client requires the most immediate intervention by the nurse?
- A. A client with acute kidney injury who is somnolent and does not respond to verbal commands.
- B. An older adult receiving enteral feedings via feeding tube who has a temperature of 100.6 F (38.1 C).
- C. A young adult who experienced heat stroke and is receiving a normal saline intravenous (IV) fluid bolus.
- D. A pregnant client with hyperemesis gravidarum who is receiving an infusion of Ringer's Lactate.
Correct Answer: A
Rationale: Somnolence in acute kidney injury suggests uremic encephalopathy, requiring immediate neurological assessment.