As a nurse manager, you introduce a program that allows staff to participate in mock drills for emergency preparedness. Your rationale is that mock drills:
- A. Reduce staff accountability
- B. Increase staff confidence in emergencies
- C. Reduce patient safety
- D. Increase managerial control
Correct Answer: B
Rationale: Mock drills boost staff confidence practicing emergencies (e.g., codes) sharpens skills, cutting panic. They don't cut accountability, harm safety, or hike control readiness grows. In your unit, this preps for crises, aligning with safety where trained nurses act decisively, enhancing outcomes and team poise, a proactive step for high-stakes moments.
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The chief nursing officer decided that the nurse managers need a series of staff-development programs on team building through communication and partnerships. She understood that the nurse managers needed to build confidence in ways of handling various situations. The greatest deterrent to confidence is:
- A. lack of clarity in the mission
- B. lack of control of the environment
- C. fear that one can't handle the consequences
- D. fear that the boss will not like one's work
Correct Answer: C
Rationale: Confidence in managing situations like team conflicts erodes most when nurse managers fear they can't handle outcomes, such as unresolved disputes or poor team performance. The CNO's focus on communication and partnerships aims to bolster this, as fear of consequences undermines competence and decision-making. Unclear missions or uncontrolled environments challenge leadership, but the personal dread of failure is more paralyzing. Fear of disapproval is less critical than managing tangible results. Building skills to navigate consequences directly boosts confidence, addressing the core barrier identified here.
A nurse is ambulating a client who has an IV with an infusion pump. After the nurse returns the client to his room and plugs in the infusion pump, the client reports a slight tingling in his hand. Which of the following actions should the nurse take?
- A. Turn off the pump
- B. Increase the infusion rate
- C. Tape the cord
- D. Notify maintenance only
Correct Answer: A
Rationale: Tingling in the hand after plugging in an IV pump suggests electrical malfunction possibly a short circuit or grounding issue posing shock or fire risks. Turning off the pump immediately halts potential harm, prioritizing client and staff safety, allowing assessment (e.g., cord damage) and tagging for repair. Increasing the rate ignores the symptom, worsening exposure, while taping the cord assumes a fix without evidence, delaying resolution. Notifying maintenance alone prolongs risk until they arrive. Shutting off aligns with safety-first principles, mitigating electrical hazards swiftly, critical in a clinical setting where equipment failure can escalate, ensuring protection until a full check confirms functionality.
The nurse is applying a decision-making process to a clinical challenge. When applying this process, the nurse must:
- A. analyze the root causes of a situation
- B. begin by solving the underlying problem
- C. choose between different courses of action
- D. prioritize the maximum good for the maximum number of people
Correct Answer: C
Rationale: In nursing, decision making involves selecting a course of action, as this nurse must do amidst a clinical challenge. Analyzing root causes or solving problems first are steps within problem solving a systematic subset of decision making but the core act is choosing, like opting for one treatment over another. Prioritizing the maximum good aligns with utilitarian ethics, but nursing often lacks the scope for such broad impact in single decisions. For instance, faced with a patient's deteriorating vitals, the nurse chooses between immediate intervention or monitoring, weighing options based on data and protocols. This choice-driven process, distinct from exhaustive analysis, empowers nurses to act decisively in dynamic settings, ensuring patient safety and care quality, a critical leadership skill in managing clinical uncertainties effectively.
A nurse from a facility's float pool receives an assignment to float on a nursing unit. The float nurse tells the charge nurse that she has never worked on this unit before. How should the charge nurse respond?
- A. I will assign you to work with a registered nurse on the unit who is experienced and will act as a resource for you'
- B. You'll figure it out as you go'
- C. I'll reassign you elsewhere'
- D. Work only with the AP staff'
Correct Answer: A
Rationale: A float nurse unfamiliar with a unit needs support to ensure competent care. Responding I will assign you to work with a registered nurse on the unit who is experienced and will act as a resource for you' provides a skilled mentor, easing the transition with real-time guidance on unit specifics protocols, clients, equipment. This leverages the float pool's purpose, builds capacity, and safeguards quality, especially with likely future floats. Figure it out' risks errors from inexperience, reassigning wastes resources, and limiting to APs restricts scope and learning. Pairing with an RN fosters collaboration, confidence, and safety, aligning with leadership's role in resource allocation and staff development.
A nurse is reviewing the laboratory results of a client who is scheduled for surgery. Which of the following results should the nurse report to the provider?
- A. Potassium 3.8 mEq/L
- B. Hemoglobin 7.8 g/dL
- C. Sodium 140 mEq/L
- D. Creatinine 0.9 mg/dL
Correct Answer: B
Rationale: Preoperative lab review identifies risks impacting surgery anemia, electrolytes, or organ function. Hemoglobin 7.8 g/dL below the normal 12-15 g/dL for females or 13-17 g/dL for males indicates anemia, reducing oxygen-carrying capacity, a concern for anesthesia and healing, warranting provider notification for possible transfusion or delay. Potassium 3.8 mEq/L (normal 3.5-5.0), sodium 140 mEq/L (135-145), and creatinine 0.9 mg/dL (0.6-1.2) are within range, posing no immediate threat. Low hemoglobin directly affects surgical safety, triggering urgent communication to adjust the plan, ensuring optimal oxygenation and recovery, a critical nursing responsibility in preoperative care coordination.
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