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As a new nurse manager who has 'inherited' a unit with high nurse turnover and complaints of patient dissatisfaction, your first course of action would be to:
- A. Determine levels of nurse engagement on the unit
- B. Review the personnel files of nurses who have resigned
- C. Interview upper management about their vision for the unit
- D. Meet with your staff to clarify your vision for the unit
Correct Answer: A
Rationale: High turnover and patient dissatisfaction often stem from low nurse engagement disconnection from work or leadership impacting care quality. As a new manager, assessing engagement through observation, surveys, or discussions reveals root causes, like poor morale or autonomy, guiding targeted improvements. Reviewing files offers historical data but not current dynamics. Interviewing management or sharing your vision comes later understanding staff engagement first grounds your strategy in the unit's reality. Studies (e.g., Aiken) show engaged nurses improve outcomes and retention, making this the critical starting point to address both issues effectively.
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The nurse is caring for a client with an indwelling urinary catheter. Which intervention is the priority to prevent infection?
- A. Empty the drainage bag every 8 hours
- B. Secure the catheter to the leg
- C. Clean the insertion site daily
- D. Encourage fluid intake
Correct Answer: C
Rationale: With an indwelling catheter, clean the site daily is priority, not emptying, securing, or fluids. Cleaning cuts infection others help but germs at entry matter most. Leadership ensures this imagine cloudy urine; it prevents UTI, aligning with catheter care effectively.
A nurse is reviewing informed consent with a client who is scheduled for a cardiac catheterization. Which of the following is the responsibility of the nurse?
- A. Explaining the procedure's risks
- B. Obtaining the client's signature
- C. Verifying the client's understanding of the procedure being performed
- D. Scheduling the procedure
Correct Answer: C
Rationale: The nurse's role in informed consent is to ensure the client comprehends the procedure, supporting autonomy and legal standards. Verifying the client's understanding of the cardiac catheterization its purpose, process, and implications confirms they can articulate it, ensuring consent is truly informed, not just signed. Explaining risks is the provider's duty, as they perform the procedure and bear legal responsibility for disclosure. Obtaining the signature is procedural but secondary to comprehension, often a clerical task. Scheduling is logistical, unrelated to consent. Verification bridges provider explanation and client decision, empowering the client and protecting the healthcare team by validating that consent reflects genuine understanding, not coercion or confusion.
A client with a history of hypertension is prescribed hydrochlorothiazide. Which laboratory value should the nurse monitor?
- A. Potassium
- B. Calcium
- C. Magnesium
- D. Sodium
Correct Answer: A
Rationale: For hydrochlorothiazide in HTN, monitor potassium, not calcium, magnesium, or sodium. Thiazides dump potassium hypokalemia risks arrhythmias. Others shift less. Leadership watches this imagine cramps; it ensures safety, aligning with HTN care effectively.
A recent nursing graduate in a busy Emergency Department triages a patient who has sustained a large, deep puncture wound in his foot while working at a construction site. He is bleeding and is in pain. The nurse enters the triage data that she has obtained from the patient into a computerized, standard emergency patient-classification system. After she enters the assessment data, she notices an alert on the computer screen that prompts her to ask the patient about the status of his tetanus immunization. What system of technology is involved in generating the alert?
- A. Clinical decision support
- B. WL technology
- C. Computerized provider order
- D. Electronic health record
Correct Answer: A
Rationale: The alert prompting the nurse to check the patient's tetanus status comes from a clinical decision support (CDS) system. CDS integrates patient data like the puncture wound details with evidence-based guidelines, flagging risks such as tetanus exposure from a dirty wound. This real-time guidance enhances decision-making, especially critical in a busy ED where a new graduate might overlook such details. Wireless technology supports connectivity, not decision prompts. Computerized provider order systems focus on ordering, not alerts. Electronic health records store data but don't inherently generate clinical prompts without CDS integration. Here, CDS actively supports the nurse by identifying a key intervention, improving patient safety.
As a nurse manager, you introduce a program that enables staff nurses to recognize peers for teamwork and exceptional patient care with care awards.' Your rationale for this program is that peer recognition:
- A. Increases staff accountability
- B. Reduces organizational conflict
- C. Increases job satisfaction
- D. Reduces the need for managerial oversight
Correct Answer: C
Rationale: Peer care awards' for teamwork and care boost job satisfaction nurses feel valued by colleagues, lifting morale, as studies link recognition to engagement. It's not primarily about accountability, conflict, or less oversight, though it may ease tensions. In your unit, this fosters positivity amid stress, reinforcing good practice via peer praise, a low-cost, high-impact way to enhance fulfillment and retention, aligning with morale-building goals.