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As a nurse manager, which of the following best describes this function?
- A. Initiate modification on client's lifestyle
- B. Protect client's right
- C. Coordinates the activities of other members of the health team in managing patient care
- D. Provide in service education programs, Use accurate nursing audit, formulate philosophy and vision of the institution
Correct Answer: D
Rationale: A nurse manager's role encompasses planning (vision formulation), organizing (team coordination), directing (training), and controlling (audits), per management theories like Venzon's. This holistic function e.g., setting care standards, training staff, evaluating outcomes ensures quality across a unit, unlike narrower roles like lifestyle change (change agent), rights protection (advocate), or team coordination (case manager). It's a strategic position driving institutional excellence, pivotal in healthcare leadership.
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The nurse working in the community is assigned to the care of several clients. Which client(s) may require assistance to overcome barriers to accessing adequate care?
- A. A student entering a local university
- B. A client who is a migrant and works on a farm
- C. An older adult client living independently
- D. A client who has been unemployed for 6 months
Correct Answer: B
Rationale: Barriers to healthcare access often hit vulnerable groups hardest, requiring nursing intervention. A migrant farm worker faces language, mobility, and economic hurdles, limiting care access e.g., no insurance or transport. An older adult living alone may struggle with mobility, health literacy, or isolation, delaying treatment. An unemployed client, lacking income or coverage, often skips care due to cost, risking worsening conditions. A student entering university or an employed pregnant client typically has fewer systemic barriers students may access campus health, employed clients insurance. Nursing must target the migrant, elderly, and jobless, addressing disparities poverty, age, ethnicity ensuring equitable care. This reflects nursing's equity mission, bridging gaps for those society sidelines, enhancing health outcomes through advocacy and resource linkage.
Which of the following statement is NOT true about care transition?
- A. Moving between care settings
- B. Involves communication
- C. Only occurs in hospitals
- D. May affect outcomes
Correct Answer: C
Rationale: Care transition moves between settings (A), involves communication (B), affects outcomes (D) 'only in hospitals' (C) isn't true, includes home, per process. C's limit fails, making it untrue.
The client you are assigned to has four nursing diagnoses. Which of the following would you assign the highest priority?
- A. chest pain related to cough secondary to pneumonia
- B. self-care deficit related to activity intolerance secondary to sleep-pattern disturbance
- C. risk for altered family processes secondary to hospitalization
- D. self-esteem deficit situational
Correct Answer: A
Rationale: Among four diagnoses, chest pain related to pneumonia takes highest priority because it addresses a physiologic need breathing and circulation per Maslow's hierarchy. Pain and potential respiratory compromise threaten survival, requiring immediate intervention like medication or oxygen. Self-care deficits, family process risks, and self-esteem issues, while important, are less urgent, impacting higher-level needs like independence or esteem. Prioritizing chest pain ensures the client's airway and oxygenation are stabilized, preventing deterioration, a fundamental principle in acute care nursing.
The physician has ordered amitriptyline (Elavil) for a client with depression. The nurse should tell the client that:
- A. The medication will produce a rapid improvement in mood
- B. He might experience difficulty with urination
- C. He should avoid milk products while taking the medication
- D. The medication should be discontinued if he experiences dry mouth
Correct Answer: B
Rationale: Difficulty with urination is a common amitriptyline side effect (anticholinergic), needing monitoring mood improvement takes weeks, milk isn't restricted, and dry mouth doesn't warrant stopping. Nurses teach this, managing expectations, ensuring adherence in depression treatment.
The nurse is suctioning a client through a tracheostomy tube. During the procedure, the client begins to cough, and the nurse notes the presence of an audible wheeze. The nurse attempts to remove the suction catheter from the client's trachea but is unable to do so. What is the nurse's priority response?
- A. Call a code.
- B. Administer a bronchodilator.
- C. Contact the health care provider.
- D. Disconnect the suction source from the catheter.
Correct Answer: D
Rationale: A stuck catheter with coughing and wheezing suggests obstruction or bronchospasm; disconnecting the suction source (D) is the priority to relieve pressure and attempt removal. Calling a code (A) or provider (C) delays action. Bronchodilators (B) treat wheezing but not the immediate issue. D is correct. Rationale: Disconnecting stops suction trauma, allowing catheter withdrawal and airway reassessment, a critical first step per emergency airway protocols.