Nokea
An RN makes the following assignments at the beginning of the shift. Which assignment would be considered high-risk delegation?
- A. A novice RN is assigned a patient with diabetes mellitus requiring mixing of regular and NPH insulin.
- B. An LPN is assigned an older adult with pneumonia and who requires dressing changes on a foot wound.
- C. An unlicensed assistive person is assigned the task of assisting a patient with late stages of Huntington's disease to ambulate a short distance in the hallway.
- D. A float RN from the oncology unit is assigned a patient with a white blood cell count of 4000 mm
Correct Answer: A
Rationale: The correct answer is A because it involves a high-risk delegation. Mixing insulin is a complex task that requires precise measurements and understanding of the patient's condition. A novice RN may lack the experience and knowledge to safely perform this task, leading to potential harm for the patient.
Choice B involves wound care, which is within an LPN's scope of practice and not as high-risk as insulin administration. Choice C involves basic ambulation assistance, which is appropriate for an unlicensed assistive person under supervision. Choice D involves caring for a patient with low white blood cell count, which may be challenging but not as high-risk as insulin mixing for a novice RN.
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When the job applicant is asked to identify weaknesses, one appropriate reply for the novice nurse might be:
- A. "I have no weaknesses."
- B. "Are you trying to set me up?"
- C. "Delegating to peers."
- D. "Caring requires weakness."
Correct Answer: C
Rationale: The correct answer is C: "Delegating to peers." This response shows self-awareness and willingness to improve by acknowledging a common weakness for novice nurses - difficulty in delegating tasks to peers. It demonstrates a willingness to learn and grow in the role.
A: "I have no weaknesses." - This answer lacks self-awareness and does not show a willingness to improve. It comes across as overconfident.
B: "Are you trying to set me up?" - This response is defensive and unprofessional. It does not address the question directly.
D: "Caring requires weakness." - This answer is vague and does not provide a specific weakness or show a proactive approach to self-improvement.
A novice nurse notices a patient is pacing the floor and twisting his hands. When the nurse enters the room, the patient stares at her and mumbles, "Can't anyone understand what I want?" while smiling and reaching out to shake the nurse's hand. The nurse recognizes a risk for violence based on which clinical findings? (select all that apply)
- A. Glaring at the nurse
- B. Nervousness, twisting of hands
- C. Murmuring when talking
- D. Diagnosis of a terminal illness
Correct Answer: A
Rationale: The correct answer is A because glaring at the nurse indicates potential aggression and hostility, which are red flags for violence risk. Glaring can be a non-verbal sign of anger or frustration, signaling a potential escalation. In contrast, nervousness and twisting of hands (choice B) may indicate anxiety or distress but not necessarily violence. Murmuring when talking (choice C) may suggest communication difficulties but does not directly indicate violence risk. Lastly, a diagnosis of a terminal illness (choice D) is not directly related to the immediate risk of violence in this scenario.
In recent Gallop Polls, nurses were voted as the most honest with the highest ethical standards of all professions. How does this degree of professionalism affect nurses' desire to participate in organized strikes?
- A. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client safety initiatives.
- B. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization.
- C. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession.
- D. Nurses who strike can be legally punished for abandonment and negligence, considered to be professional misconduct.
Correct Answer: C
Rationale: The correct answer is C because nurses being voted as the most honest and ethical profession indicates their strong commitment to patient care and ethics. Therefore, nurses may find participating in strikes conflicting with their core values of serving and protecting patients. This conflict can deter nurses from engaging in union activities like strikes, as they prioritize patient well-being over their own interests.
A is incorrect because while nurses prioritize client safety, participating in strikes may not always align with this goal. B is incorrect as evidence-based studies may support various perspectives, but nurses' ethical standards and commitment to patient care are the primary factors influencing their decision to engage in strikes. D is incorrect as legal repercussions for striking nurses focus on professional misconduct rather than the ethical dilemma nurses face when considering strikes.
A student nurse assigned to work with the charge nurse is given the opportunity to help revise the nursing assessment form. She receives several compliments from management and her nursing instructor for her creative suggestions. The student nurse enjoys the project and attention she is receiving and begins to prolong the conclusion of the project. Although she constantly adds new information, she filters this out slowly to others. The student nurse is subject to the time management obstacle of:
- A. need for perfection.
- B. fear of losing creativity.
- C. unclear goals.
- D. fear of completion.
Correct Answer: D
Rationale: The correct answer is D: fear of completion. This is because the student nurse is prolonging the conclusion of the project despite constantly adding new information and filtering it out slowly to others. This behavior indicates a reluctance to finish the project, likely due to a fear of moving on to the next stage or fear of evaluation. The student nurse is enjoying the attention and positive feedback, leading to a delay in completing the task.
A: The need for perfection is not the primary obstacle in this scenario as the student nurse is not necessarily striving for perfection but rather avoiding completion.
B: Fear of losing creativity is not the main issue here as the student nurse is still adding new information, indicating creativity is not the concern.
C: Unclear goals do not seem to be the obstacle as the student nurse is actively engaged in the project and receiving positive feedback.
A nurse is hoping for a promotion and seeks the help of a coach to improve time management skills. The first task assigned by the coach is for the nurse to list all external distractors that prevent organization and completion of tasks. The nurse would include:
- A. waiting for oncoming shift to start walking rounds.
- B. failure to delegate tasks to the licensed practical nurse and unlicensed assistive personnel and instead, completing task herself.
- C. talking with a patient's family member who is also a personal friend.
- D. spending time thinking about the vacation to the beach.
Correct Answer: A
Rationale: The correct answer is A because waiting for the oncoming shift to start walking rounds is an external distractor that can affect time management. The nurse cannot control when the shift starts, leading to potential delays in task completion.
Incorrect choices:
B: Failure to delegate tasks is an internal issue, not an external distractor.
C: Talking with a patient's family member who is a personal friend is a boundary issue, not necessarily an external distractor.
D: Thinking about a vacation is also an internal distraction, not an external one.
In summary, the correct answer focuses on an external factor that the nurse cannot directly control, affecting time management, while the other choices are related to internal issues or personal boundaries.