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An older female client who was recently widowed has become increasingly confused and disoriented. Her family tells the healthcare provider's office nurse that it is imperative for their mother to be admitted to the hospital for medical evaluation. The client is a member of a managed healthcare plan. Which information is best for the nurse to provide this family?
- A. The client is grieving normally in response to her husband's death and hospitalization is not necessary.
- B. Managed care providers have mandatory pre-certification requirements for hospitalization.
- C. Healthcare costs are escalating because clients want to have diagnostic testing conducted in the hospital.
- D. Managed healthcare plans do not pay for any in-hospital medical evaluations.
Correct Answer: B
Rationale: Informing the family about pre-certification requirements explains the process for hospital admission under the managed care plan.
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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.
The healthcare provider prescribes an oral medication to be given daily for 3 days. However, the medication was also given on the fourth day. Which intervention is most important for the charge nurse to implement?
- A. Review the medication transcription with the nurse.
- B. Evaluate the client for symptoms of a drug interaction.
- C. Report the medication error to the nursing supervisor.
- D. Inform the pharmacist who dispensed the medication.
Correct Answer: C
Rationale: Reporting the error ensures proper documentation and follow-up for client safety.
When making assignments for residents of a long-term care facility who require assistance with feeding, which client should the charge nurse assign to the practical nurse (PN) rather than the unlicensed assistive personnel (UAP)?
- A. An elderly woman who refuses to eat most meals served.
- B. A disabled client who is learning to use adaptive equipment.
- C. A client who drools but swallows solids after many attempts.
- D. An older, edentulous client who has loose fitting dentures.
Correct Answer: A
Rationale: The client refusing meals requires a PN's assessment to address potential psychological or physiological issues.
An unlicensed assistive personnel (UAP) who is working on a skilled nursing unit is diagnosed with hepatitis A (HVA). Two weeks later, a nurse complains of headache, nausea, anorexia, arthralgia, and low-grade fever. Which action should the nurse-manager take next?
- A. Observe the nurse for jaundice and icterus sclera.
- B. Review the immunization status of all unit employees.
- C. Refer the nurse to employee health for serological testing.
- D. Post an employee notice of the outbreak of HVA on the unit.
Correct Answer: C
Rationale: Serological testing confirms HVA, enabling prompt diagnosis and treatment.
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 number of clients leaving the unit for diagnostic tests.
- B. The acuity level of the clients on the unit.
- C. The physician's plans to perform procedures on the unit.
- D. The skill level of the personnel staffing the unit.
Correct Answer: B
Rationale: Client acuity determines the intensity of care needed, critical for staffing decisions.