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An experienced, female practical nurse (PN) is hired to work on the surgical unit of a tertiary hospital. The first day she is working on the unit, the PN tells the charge nurse that she has excellent wound care skills. It is a busy day and a postoperative client needs to have a sterile dressing change. Which action is best for the charge nurse to take?
- A. Review the PN's skill checklist to assess for wound care competency.
- B. Watch the PN perform sterile wound care to validate her skill level.
- C. Tell the PN that past experience does not indicate ability to perform skills.
- D. Ask the PN to change the sterile dressing while the nurse is busy.
Correct Answer: B
Rationale: Observing the PN perform wound care ensures her skills meet standards, protecting client safety. Reviewing a checklist, dismissing experience, or delegating without verification are less effective.
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The charge nurse needs to determine if an additional nurse should be called to help staff the unit for the next shift. Which information is most important for the charge nurse to consider when making this decision?
- A. The acuity level of the clients on the unit.
- B. The physicians' plans to perform procedures on the unit.
- C. The number of clients leaving the unit for diagnostic tests.
- D. The skill level of the personnel staffing the unit.
Correct Answer: A
Rationale: Client acuity determines the intensity of care needed, directly impacting staffing requirements. Procedures, diagnostic tests, and staff skills are secondary considerations.
The nurse manager overhears an older female nurse complaining to a co-worker about the time being used to attend an in-service session for bioterrorism preparedness. How should the nurse manager respond?
- A. Choose to send another nurse who is more receptive because the older nurse is not interested.
- B. Ask the nurse why she thinks there is no need for an in-service program about these emergencies.
- C. Inform the older nurse that in-service is not optional and her scheduled attendance is mandatory.
- D. Encourage the nurse to share her concerns and discuss ways to prepare for such emergencies.
Correct Answer: D
Rationale: Encouraging the nurse to share concerns fosters collaboration and addresses barriers to participation, enhancing engagement. Sending another nurse, questioning her views confrontationally, or mandating attendance may create resentment or fail to address her concerns effectively.
A newly hired unlicensed assistive personnel (UAP) expresses fear to the charge nurse about collecting a sputum specimen from a client who is HIV positive. Which action should the charge nurse take first?
- A. Demonstrate the proper use of personal protective equipment.
- B. Offer to assist the UAP with the collection of the specimen.
- C. Provide the UAP with the infection control policy.
- D. Determine the UAP's knowledge about HIV transmission.
Correct Answer: D
Rationale: Determining the UAP's knowledge about HIV transmission is the first step to address misconceptions and fears, enabling targeted education. Demonstrating PPE, assisting with collection, or providing policy are secondary actions that follow understanding the UAP's knowledge gaps.
The smell of cigarette smoke is coming from a client's bathroom. Which action should the nurse implement first?
- A. Document the occurrence in the client's record.
- B. Obtain a prescription for a nicotine patch during hospitalization.
- C. Educate the client about the hospital smoking policy.
- D. Notify the charge nurse about the situation immediately.
Correct Answer: D
Rationale: Notifying the charge nurse ensures immediate enforcement of the no-smoking policy to prevent fire risks. Documenting, prescribing patches, or educating are secondary actions.
Four clients are scheduled to receive IV infusions, but there are only three intravenous (IV) pumps available. Which prescribed infusion can most safely be administered without an IV infusion pump?
- A. Ceftriaxone in 5% Dextrose in Water prescribed for pneumonia.
- B. Heparin in Normal Saline prescribed for deep vein thrombosis.
- C. Magnesium in Normal Saline prescribed for hypomagnesemia.
- D. Regular insulin in Normal Saline prescribed for ketoacidosis.
Correct Answer: A
Rationale: Ceftriaxone can be safely administered by gravity infusion with nurse monitoring, as its dosing is less sensitive to minor flow rate variations. Heparin, magnesium, and insulin require precise infusion rates due to risks of bleeding, toxicity, or glucose imbalances, necessitating an IV pump.