Nokea
An RN on your unit has had an argument with the family of a client regarding the way in which the RN has changed the client's dressing. The family is adamant that the dressing change was performed incorrectly. The RN insists that sterile technique was observed. As an RN manager, what is the best response?
- A. Meet with the family member and the RN to discuss the disagreement regarding the dressing change.
- B. Talk to the family member and assure them that the nurse followed the hospital procedure.
- C. Discuss the dressing change procedure with the RN and compare it to a current textbook.
- D. Change the RN's assignment the next day to another client.
Correct Answer: A
Rationale: When conflict occurs, it is best to meet with both parties together to discuss the problem. This approach allows each party to hear what the other is saying and prevents the RN manager from being caught in the middle. By facilitating a discussion between the family member and the RN, they can work together to find a resolution or the manager can mediate. This promotes open communication, understanding, and collaboration. Option A is the correct choice because it emphasizes addressing the conflict directly and seeking a mutual understanding. Option B is incorrect because just assuring the family member may not address the underlying issues. Option C is incorrect as it does not involve the family member in the resolution process. Option D is inappropriate as it doesn't address the conflict but rather avoids it by changing the RN's assignment.
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Which action by a graduate nurse would require the charge nurse to intervene?
- A. Walking in the hallway outside the operating room without a hair covering
- B. Putting on a surgical mask, gown, and cap before entering the operating room
- C. Wearing a surgical mask into the holding area
- D. Wearing scrubs from home into the nursing station
Correct Answer: A
Rationale: The correct answer is walking in the hallway outside the operating room without a hair covering. In healthcare settings, it is crucial to adhere to infection control measures, which include wearing appropriate attire to prevent the spread of pathogens. Walking in the hallway outside the operating room without a hair covering violates these infection control protocols, necessitating immediate intervention by the charge nurse. Choices B and C are incorrect because putting on surgical attire before entering the operating room and wearing a surgical mask into the holding area are both standard practices that promote patient safety and infection control. Choice D is also incorrect as wearing scrubs from home into the nursing station, while not ideal, is not a violation that warrants immediate intervention compared to breaching infection control protocols near sensitive areas like the operating room.
A 62-year-old female is being seen on a home visit by a nurse. The patient reports she has been taking Premarin for years. Which of the following would indicate an overdose?
- A. Lower extremity edema
- B. Sensory changes in the upper extremities
- C. Increased occurrence of fractures
- D. Decreased peripheral blood flow
Correct Answer: A
Rationale: Lower extremity edema can indicate an overdose of Premarin. Premarin, an estrogen hormone replacement therapy, can cause fluid retention leading to edema in the lower extremities. Sensory changes in the upper extremities, increased occurrence of fractures, and decreased peripheral blood flow are not typically associated with an overdose of Premarin.
The nurse is caring for a client who is 28 weeks pregnant and complains of swollen hands and feet. Which symptom below would cause the greatest concern?
- A. Nasal congestion
- B. Hiccups
- C. Blood glucose of 150
- D. Muscle spasms
Correct Answer: D
Rationale: The correct answer is muscle spasms because they can be indicative of a severe condition like preeclampsia, which is a serious complication during pregnancy characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. Nasal congestion and hiccups are common discomforts during pregnancy and do not pose a severe risk to the client or fetus. A blood glucose level of 150, while slightly elevated, may not be alarming in a pregnant individual and can be managed through dietary modifications or medication adjustments. Muscle spasms, especially in the context of pregnancy, should be taken seriously and thoroughly assessed to rule out any underlying serious conditions.
The emergency department charge nurse is reviewing the clients triaged in the last 30 minutes. The nurse is required to obtain a social service consult from which of the following clients?
- A. A 6-year-old who drank some diluted bleach.
- B. A 10-year-old who suffered burns in a house fire.
- C. A 12-year-old who fractured his arm in a fight at school.
- D. A 12-month-old without any oral intake for the last 12 hours.
Correct Answer: A
Rationale: For children under 7 years, most states have laws that mandate reporting certain situations to social services or child protection, such as ingestions of toxic substances, fractures, suspected neglect, or abuse, and burns. In this scenario, the 6-year-old who drank diluted bleach falls under the category that requires a social service consult. The other choices involve injuries or conditions that may warrant medical attention but do not necessarily mandate a social service consult based on age-related legal requirements.
What is the number one reason a person with alcohol addiction does not seek treatment?
- A. Co-dependency
- B. Denial
- C. Depression
- D. Stigma
Correct Answer: B
Rationale: The correct answer is B: Denial. Individuals with alcohol addiction often deny that they have a drinking problem and may become defensive when confronted about it. This sense of denial can be a significant barrier to seeking treatment. Co-dependency, referred to in choice A, is a relationship dynamic and is not the primary reason for avoiding treatment. Depression, as mentioned in choice C, is a common co-occurring condition with alcohol addiction but is not typically the main factor preventing treatment-seeking. Stigma, as in choice D, can act as a deterrent, but denial of the problem itself is usually the primary obstacle to seeking help.