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An experienced nurse tells the nurse-manager that working with a new graduate is impossible because the new graduate will not listen to suggestions. The new graduate comes to the nurse-manager describing the senior nurse's attitude as challenging and offensive. What action is best for the nurse manager to take?
- A. Have both nurses meet separately with the staff mental health consultant
- B. Listen actively to both nurses and offer suggestions to solve the dilemma
- C. Ask the senior nurse to examine mentoring strategies used with the new graduate
- D. Ask the nurses to meet with the nurse-manager to identify ways of working together
Correct Answer: D
Rationale: In this scenario, the best action for the nurse manager to take is to ask the nurses to meet with the nurse-manager to identify ways of working together. This approach promotes open communication, facilitates understanding of both perspectives, and encourages collaborative problem-solving. Option A is not ideal as involving a mental health consultant may be premature for this situation. Option B, although helpful in listening to both parties, does not directly address the need for collaboration. Option C focuses on the senior nurse's mentoring strategies only, rather than addressing the conflict between the two nurses.
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When assessing a client several hours after surgery, the nurse observes that the client grimaces and guards the incision while moving in bed. The client is diaphoretic, has a radial pulse rate of 110 beats/min, and a respiratory rate of 35 breaths/min. What assessment should the nurse perform first?
- A. Apical heart rate
- B. IV site and fluids
- C. Pain scale
- D. Temperature
Correct Answer: C
Rationale: The client's grimacing and guarding suggest pain; assessing the pain scale is crucial for addressing the discomfort. Pain management is a priority to ensure the client's well-being and comfort. Checking the apical heart rate, IV site and fluids, or temperature can be important but addressing the client's pain takes precedence in this scenario. The elevated pulse rate and respiratory rate could be indicative of pain, making the pain scale assessment essential to guide appropriate interventions.
A client who is diagnosed with amyotrophic lateral sclerosis (ALS) is having difficulty swallowing and articulating words. Which intervention is most important to include in this client's plan of care?
- A. Encourage speaking slowly and articulating words
- B. Sit upright and flex chin forward while swallowing
- C. Position a communication board at the bedside
- D. Provide feeding utensils with large grip handles
Correct Answer: B
Rationale: The correct intervention for a client with ALS experiencing difficulty swallowing and articulating words is to sit upright and flex the chin forward while swallowing. This position helps manage dysphagia associated with ALS by facilitating the swallowing process. Encouraging speaking slowly and articulating words (Choice A) may be helpful for speech clarity but does not address the swallowing issue. Positioning a communication board (Choice C) would not directly address the swallowing difficulty. Providing feeding utensils with large grip handles (Choice D) is not the priority intervention for managing dysphagia in ALS.
An older male resident of a long-term care facility has been scratching his legs for the past 2 days. Which intervention should the nurse implement?
- A. Explain the importance of bathing or showering daily
- B. Encourage fluid intake of at least 2,000 ml daily
- C. Keep the legs covered as much as possible
- D. Apply emollient to the affected area at least twice daily
Correct Answer: D
Rationale: The correct intervention for the nurse to implement in this scenario is to apply emollient to the affected area at least twice daily. This is because applying emollients helps address dry skin, which is a common cause of itching in older adults. Explaining the importance of bathing or showering daily (Choice A) may be helpful for general hygiene but may not specifically address the itching. Encouraging fluid intake (Choice B) and keeping the legs covered (Choice C) are not directly related to addressing the itching caused by dry skin.
A young adult woman visits the clinic and learns that she is positive for BRCA1 gene mutation and asks the nurse what to expect next. How should the nurse respond?
- A. Explain that counseling will be provided to give her information about her cancer risk.
- B. Gather additional information about the client's family history for all types of cancer.
- C. Offer assurance that there are a variety of effective treatments for breast cancer.
- D. Provide information about survival rates for women who have this genetic mutation.
Correct Answer: A
Rationale: The correct answer is A because counseling will help the woman understand her risk and options for surveillance or preventive measures. At this point, it is crucial to address the woman's immediate concerns related to the BRCA1 gene mutation. Choice B is incorrect as the focus should be on the woman's individual risk due to the specific gene mutation she carries. Choice C is not the priority as treatment options come after assessing the risk and deciding on surveillance or preventive measures. Choice D is incorrect because discussing survival rates is not the immediate need for someone who has just received information about having a genetic mutation.
A client presents to the healthcare provider with fatigue, poor appetite, general malaise, and vague joint pain that improves mid-morning. The client has been using over-the-counter ibuprofen for several months. The healthcare provider makes an initial diagnosis of rheumatoid arthritis (RA). Which laboratory test should the nurse report to the healthcare provider?
- A. Sedimentation rate
- B. White blood cell count
- C. Anti-CCP antibodies
- D. Activated Clotting Time
Correct Answer: A
Rationale: The correct answer is A: Sedimentation rate. Sedimentation rate, Anti-CCP antibodies, and C-reactive protein are commonly used laboratory tests to indicate inflammation and help diagnose rheumatoid arthritis. An elevated sedimentation rate is a nonspecific indicator of inflammation in the body, which is often seen in RA. White blood cell count is not specific for RA and is not typically significant in the diagnosis. Anti-CCP antibodies are specific to RA and are useful in confirming the diagnosis. Activated Clotting Time is not relevant to the diagnosis of rheumatoid arthritis as it is not specific to this condition.