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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: The correct answer is D. The nurse-manager should ask the nurses to meet to identify ways of working together. This is the best action because it promotes open communication, collaboration, and conflict resolution between the two nurses. By facilitating a discussion between them, the nurse-manager can help address the underlying issues, clarify misunderstandings, and find common ground for effective teamwork. This approach encourages mutual understanding and fosters a positive working relationship.
A: Having both nurses meet separately with the staff mental health consultant does not directly address the conflict between them.
B: While listening actively and offering suggestions is important, involving both nurses in the discussion is crucial for resolving the conflict.
C: Asking the senior nurse to examine mentoring strategies does not involve the new graduate in the conversation and may not address the overall issue.
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A client with type 1 diabetes mellitus reports feeling shaky and has a blood glucose level of 60 mg/dl. What action should the nurse take?
- A. Administer 15 grams of carbohydrate
- B. Administer a glucagon injection
- C. Provide a snack with protein
- D. Encourage the client to rest
Correct Answer: A
Rationale: The correct action is to administer 15 grams of carbohydrate because the client is experiencing hypoglycemia with a blood glucose level of 60 mg/dl. Carbohydrates will quickly raise the blood sugar level. Glucagon injection is used for severe hypoglycemia when the client is unconscious. Providing a snack with protein is not the immediate action needed to raise the blood sugar rapidly. Encouraging rest is not effective in treating hypoglycemia.
A 17-year-old female is seen in the school clinic for an evaluation of abdominal pain and dysmenorrhea. The client's last menstrual period was 3 weeks ago, and her vital signs are within normal limits. Which action should the nurse take first?
- A. Refer the client to a healthcare provider for a pelvic examination
- B. Notify the parents that the client needs to be picked up from school
- C. Determine the date of the client's last menstrual period
- D. Ask the client to lie down for a pelvic examination
Correct Answer: A
Rationale: The correct answer is A: Refer the client to a healthcare provider for a pelvic examination. This is the first action the nurse should take because the client is experiencing abdominal pain and dysmenorrhea, which could indicate a gynecological issue. A pelvic examination by a healthcare provider is necessary to assess for any potential reproductive system problems, such as ovarian cysts, endometriosis, or pelvic inflammatory disease. This examination will provide valuable information to diagnose and treat the underlying cause of the client's symptoms.
Choice B is incorrect because notifying the parents to pick up the client does not address the primary concern of evaluating the abdominal pain and dysmenorrhea. Choice C is also incorrect as determining the date of the client's last menstrual period, while important, does not take precedence over a thorough pelvic examination. Choice D is incorrect as asking the client to lie down for a pelvic examination should only be done by a healthcare provider in a proper clinical setting, not in a school clinic.
The nurse is making assignments for a new graduate from a practical nursing program who is orienting to the unit. Because the unit is particularly busy this day, there will be little time to provide supervision of this new employee. Which client is the best for the nurse to assign to this newly graduated practical nurse?
- A. Whose discharge has been delayed because of a postoperative infection
- B. With poorly controlled type 2 diabetes who is on a sliding scale for insulin administration
- C. Newly admitted with a head injury who requires frequent assessments
- D. Receiving IV heparin that is regulated based on protocol
Correct Answer: A
Rationale: The correct answer is A: Whose discharge has been delayed because of a postoperative infection. This assignment is the best choice for the new graduate nurse because a client whose discharge has been delayed due to a postoperative infection is likely stable and requires minimal immediate interventions. This client would benefit from the new nurse's routine care and monitoring skills, allowing the nurse to focus on completing tasks efficiently.
Option B: With poorly controlled type 2 diabetes who is on a sliding scale for insulin administration requires close monitoring and frequent adjustments in insulin dosages, which may be challenging for a new nurse without adequate supervision.
Option C: Newly admitted with a head injury who requires frequent assessments demands critical thinking skills and quick decision-making abilities, which may overwhelm a new nurse who lacks experience in handling such cases.
Option D: Receiving IV heparin that is regulated based on protocol involves complex medication management and monitoring for potential complications, which may be beyond the scope of a new nurse's comfort level without proper guidance.
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 liters per minute by nasal cannula. The client develops respiratory distress and the nurse increases the oxygen to 4 liters per minute. Shortly afterward, the client becomes lethargic and confused. What action should the nurse take first?
- A. Reposition the nasal cannula
- B. Lower the oxygen rate
- C. Encourage the client to cough and deep breathe
- D. Monitor the client's oxygen saturation level
Correct Answer: B
Rationale: The correct answer is B: Lower the oxygen rate. Increasing oxygen flow too quickly can lead to oxygen toxicity in COPD patients, causing symptoms like lethargy and confusion. Lowering the oxygen rate will help alleviate the symptoms and prevent further harm. Repositioning the nasal cannula (choice A) is not the priority in this situation. Encouraging coughing and deep breathing (choice C) may not address the immediate issue of oxygen toxicity. Monitoring oxygen saturation (choice D) is important but should follow lowering the oxygen rate to address the current symptoms.
A nurse is planning care for a client who is newly diagnosed with diabetes mellitus. Which instruction should the nurse include in this client¢â‚¬â„¢s teaching plan?
- A. Avoid all forms of sugar
- B. Check blood glucose levels once a week
- C. Rotate insulin injection sites
- D. Monitor urine ketone levels
Correct Answer: C
Rationale: The correct answer is C: Rotate insulin injection sites. This instruction is crucial to prevent lipohypertrophy, which can lead to inconsistent insulin absorption. By rotating injection sites, the client ensures proper insulin absorption and prevents complications. Checking blood glucose levels once a week (B) is not frequent enough for proper diabetes management. Avoiding all forms of sugar (A) is an outdated approach, as moderation is key. Monitoring urine ketone levels (D) is not as reliable as blood ketone testing for assessing diabetic ketoacidosis risk.