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An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?
- A. Use shortcuts in documentation.
- B. Only use approved abbreviations.
- C. Documentation should be subjective.
- D. Document after care is provided.
Correct Answer: B
Rationale: The correct answer is B: Only use approved abbreviations. Using approved abbreviations helps prevent misinterpretation and errors in documentation, ensuring legal credibility. Shortcuts in documentation (A) can lead to incomplete or inaccurate information. Subjective documentation (C) may lack objectivity and legal validity. Documenting after care is provided (D) may result in memory bias and inaccuracies. Therefore, emphasizing the use of approved abbreviations is crucial for ensuring accurate, clear, and legally credible nursing documentation.
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Which of the following would a nurse suggest are significant benefits to an organization that is considering adoption of a practice partnership model? (Select one that does not apply.)
- A. Clients express greater satisfaction.
- B. It is more expensive to implement than other models.
- C. Continuity of care is facilitated.
- D. Leadership is well accepted.
Correct Answer: B
Rationale: The correct answer is B because suggesting that the practice partnership model is more expensive to implement than other models would not be a significant benefit to an organization. A: Clients' greater satisfaction would be a benefit as it could lead to improved outcomes. C: Facilitated continuity of care would also be a benefit by improving coordination and patient experience. D: Leadership being well accepted is also a benefit as it can enhance organizational effectiveness.
A Staff Nurse submits a six-week notice of resignation. The Nurse Manager prepares a request to immediately post the position and begin interviews. This action is best described as which of the following?
- A. Delegation
- B. A time-waster
- C. Reactive management
- D. Proactive management
Correct Answer: D
Rationale: The correct answer is D: Proactive management. This is because the Nurse Manager is taking preemptive action by posting the position and starting interviews immediately upon receiving the resignation notice. This proactive approach ensures a smooth transition and minimizes disruptions in patient care.
Choice A, Delegation, is incorrect because the Nurse Manager is not assigning tasks to others but taking direct action. Choice B, A time-waster, is incorrect as the Manager's actions are aimed at being efficient and timely. Choice C, Reactive management, is incorrect as the Manager is not waiting for an issue to arise but is being proactive in planning for the future.
A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
- A. Urine dipstick for glucose
- B. Oral glucose tolerance test
- C. Fasting blood glucose level
- D. Glycosylated hemoglobin level
Correct Answer: D
Rationale: The correct answer is D: Glycosylated hemoglobin level. This test provides an average blood glucose level over the past 2-3 months, reflecting long-term glycemic control. It is preferred for monitoring treatment effectiveness in diabetes. Urine dipstick for glucose (A) only detects current glucose levels in urine, not overall control. Oral glucose tolerance test (B) evaluates how the body processes glucose, not long-term control. Fasting blood glucose level (C) provides a snapshot of blood glucose at a specific moment, not long-term control.
A nurse is caring for a client who has a nasogastric (NG) tube and is receiving intermittent
feedings through an open system. Which of the following actions should the nurse take first?
- A. Make sure the enteral formula is at room temperature.
- B. Wipe the top of the formula can with alcohol.
- C. Rinse the feeding bag with water between feedings.
- D. Tell the client to keep the head of the bed elevated at least 30°
Correct Answer: B
Rationale: The correct answer is B: Wipe the top of the formula can with alcohol. This is the first action the nurse should take because it ensures the cleanliness and sterility of the formula before administering it to the client through the NG tube, reducing the risk of contamination and infection.
A: Making sure the enteral formula is at room temperature is important but not the first action to take.
C: Rinsing the feeding bag with water between feedings is not necessary for every feeding and does not address the immediate need to ensure the cleanliness of the formula.
D: Instructing the client to keep the head of the bed elevated is important for preventing aspiration but is not the first action to take in this scenario.
A client complains every morning that the night shift nursing staff does not answer his call light promptly to assist his elimination needs. His concerns are not shared with the Nurse Manager, and he falls while trying to walk to the bathroom. This fall could be attributed to which of the following?
- A. Breakdown in communication
- B. Lack of staff
- C. Lack of concern
- D. Breakdown in management
Correct Answer: A
Rationale: The correct answer is A: Breakdown in communication. The client's complaint about the night shift nursing staff not responding promptly to his call light indicates a lack of effective communication between the client and the staff. This breakdown in communication leads to the client attempting to walk to the bathroom alone, resulting in a fall. Lack of staff (B) or lack of concern (C) are not directly related to the client's fall, as the core issue lies in communication. Breakdown in management (D) could contribute to communication issues, but the immediate cause of the fall is the lack of communication between the client and the nursing staff.