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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.
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A client is admitted with shortness of breath and hemoptysis. After several tests, the healthcare provider informs the client that the medical diagnosis is stage 4 breast cancer. The client tells the nurse about the decision not to inform the family about the diagnosis. Which intervention should the nurse implement?
- A. Explain that the family has a right to know of potential health problems.
- B. Advise the client to weigh all possible outcomes prior to the decision.
- C. Suggest to the family the value of genetic screening.
- D. Notify the health department of the client's condition.
Correct Answer: B
Rationale: Advising the client to weigh outcomes supports their autonomy while encouraging informed decision-making.
The charge nurse is making client assignments in the Intensive Care Department. The healthcare team consists of one nurse with 10 years experience, one nurse with 5 years experience, and a new graduate nurse who just completed a 12-week internship. Which client should the nurse assign to the new graduate nurse?
- A. A client with chest tubes secondary to a stab wound to the chest.
- B. A client in end-stage liver failure who is experiencing esophageal bleeding.
- C. A client with multisystem failure secondary to a motor vehicle collision.
- D. A client with Adult Respiratory Distress Syndrome who is on a ventilator.
Correct Answer: A
Rationale: The client with chest tubes has a stable condition suitable for the new graduate's skills.
During an evening shift on a medical unit, the only nurse on the unit is busy with an unstable client. The unit clerk, who is also both a certified medication aide and an unlicensed assistive personnel (UAP), reports to the nurse that a healthcare provider is on the telephone and wishes to prescribe an as needed (PRN) dose of an oral over-the-counter laxative for a client who is constipated. Which instruction should the nurse provide the unit clerk?
- A. Tell the healthcare provider the nurse will return the phone call as soon as possible.
- B. Remain with this client and monitor the vital signs while the nurse takes the call.
- C. Ask the healthcare provider to remain on 'hold' until the nurse can confirm the prescription.
- D. Be sure to write down what is prescribed and then repeat it back to the healthcare provider.
Correct Answer: A
Rationale: The nurse must receive prescriptions directly, prioritizing the unstable client's care.
The charge nurse is making assignments for a 15-bed skilled nursing unit with the staff of one nurse, two practical nurses (PN), and two unlicensed assistive personnel (UAP). Which client should be assigned to the PN?
- A. The client who had bilateral above-knee amputations, now has a sacral decubitus skin flap, and is receiving vancomycin intravenously.
- B. The client who is in end-stage Alzheimer's, who requires feeding, and is waiting for a long-term facility placement.
- C. The client who has pneumonia following a total knee replacement, and is receiving clarithromycin orally.
- D. The client who has right hemiplegia as the result of a cerebral vascular accident and receives continuous gastrostomy feedings per enteral pump.
Correct Answer: C
Rationale: The pneumonia client with oral medication is stable and within the PN's scope.
After implementation of new policies related to client identification prior to medication administration, the frequency of medication errors remains unchanged. Which should be the nurse manager's next action?
- A. Provide revised procedural updates through additional nursing staff education programs.
- B. Examine medication administration data to determine use of new policy by nursing staff.
- C. Investigate identified procedural variances in medication administration with nursing staff.
- D. Determine changes in procedure needed to reduce the frequency of medication errors.
Correct Answer: B
Rationale: Examining data assesses policy compliance, identifying gaps to address persistent errors.