Nokea
Which of the following conditions would be well suited to the use of a nursing critical pathway?
- A. Foreign object in the ear
- B. Fever of unknown origin
- C. Hip replacement surgery
- D. Bacterial infection acquired in a foreign country
Correct Answer: C
Rationale: The correct answer is C: Hip replacement surgery. Nursing critical pathways are designed for standardized, evidence-based care plans for specific medical conditions or procedures. Hip replacement surgery is a well-defined process with clear guidelines for pre-op, intra-op, and post-op care, making it suitable for a critical pathway. Foreign object in the ear (A) requires immediate intervention but doesn't involve a complex care pathway. Fever of unknown origin (B) requires extensive diagnostic workup, making it less suitable for a standardized pathway. Bacterial infection acquired in a foreign country (D) may have variable presentations and treatment, not fitting a standardized pathway.
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When seeking their first nursing job, what is the most important factor that nursing graduates look for?
- A. Location
- B. Money
- C. Orientation
- D. Vacation
Correct Answer: C
Rationale: The correct answer is C: Orientation. Nursing graduates prioritize orientation as the most important factor when seeking their first job because it sets the foundation for their transition into the role. A thorough orientation program provides essential training, support, and guidance, which are crucial for their success and confidence in their new position. Location (A) may be important for convenience, but orientation directly impacts their ability to perform their duties effectively. Money (B) and vacation (D) are important but typically take a back seat to factors that directly impact their ability to excel in their new role.
Which of the following would be considered an urgent and important issue?
- A. Replacing two staff who were injured while caring for a violent patient
- B. Updating the employee break room with new furniture
- C. Preparing educational packets on self-administration of insulin for patients
- D. Arranging a team-building event for staff members
Correct Answer: A
Rationale: The correct answer is A because replacing injured staff dealing with a violent patient is urgent due to staff shortage and important for patient safety. Choice B is not urgent or directly related to patient care. Choice C is important but not urgent. Choice D is important for team morale but not urgent or directly related to patient care.
A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?
- A. Document the surgeon's instructions in the client's medical record.
- B. Complete an incident report.
- C. Consult the charge nurse.
- D. Notify the nursing manager.
Correct Answer: D
Rationale: The correct answer is D: Notify the nursing manager. The nurse should escalate the situation to the nursing manager because the surgeon's instructions may not be appropriate for a client in hemorrhagic shock. The nurse needs to advocate for the client's safety and ensure prompt and appropriate intervention. Consulting the charge nurse may not be sufficient, and documenting the instructions or completing an incident report does not address the immediate need for proper medical intervention.
After working at your job for 10 months and feeling unable to tolerate the tension and stress between staff nurses and the laissez-faire nurse manager who is not a leader, what is the best course of action?
- A. Submit a resignation and leave within 30 days.
- B. Complain to staff about the nurse manager.
- C. Seek another position within the healthcare organization and apply for a transfer.
- D. Inform the chief nursing officer that you are leaving and explain your dissatisfaction with the lack of leadership.
Correct Answer: C
Rationale: The correct answer is C because seeking another position within the healthcare organization and applying for a transfer allows you to address the issue of tension and stress while staying within the organization. This option demonstrates a proactive approach to resolving the conflict and shows a commitment to finding a solution rather than just quitting. By transferring to a different position, you can potentially avoid the negative environment while still utilizing your skills and experience within the organization.
Choices A, B, and D are incorrect because they do not address the underlying issue effectively. Option A of submitting a resignation and leaving within 30 days is a hasty decision without exploring potential solutions within the organization. Option B of complaining to staff about the nurse manager may create more conflict and worsen the situation. Option D of informing the chief nursing officer about leaving does not provide a constructive solution to the tension and stress between staff nurses and the nurse manager.
A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to
- A. check glucose levels before, during, and after swimming.
- B. delay eating the noon meal until after swimming.
- C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
- D. time the morning insulin injection so that the peak occurs while swimming.
Correct Answer: A
Rationale: The correct answer is A because the patient with type 1 diabetes should check glucose levels before, during, and after swimming to monitor for fluctuations and adjust insulin or food intake accordingly. This allows for better glycemic control and prevents hypoglycemia or hyperglycemia during and after swimming.
Choice B is incorrect because delaying eating can lead to hypoglycemia during swimming due to increased insulin action without adequate glucose intake. Choice C is incorrect as increasing NPH insulin dose without monitoring glucose levels can result in hypoglycemia during exercise. Choice D is incorrect because timing the insulin injection for peak action while swimming can also lead to hypoglycemia if glucose levels are not monitored.