Nokea
Client's potassium is $7.0 \mathrm{mEq} / \mathrm{dL}$. Which prescription should the nurse administer first?
- A. Calcium gluconate IV
- B. Sodium polystyrene enema
- C. Spironolactone oral
- D. Dextrose 10\% IV
Correct Answer: A
Rationale: With potassium at 7.0 mEq/dL, calcium gluconate IV goes first, not polystyrene, spironolactone, or dextrose. Hyperkalemia risks arrhythmias calcium stabilizes cardiac membranes fast, buying time. Polystyrene lowers potassium slowly, spironolactone's diuretic, and dextrose needs insulin. Leadership acts here imagine peaked T-waves; calcium prevents arrest, ensuring safety. This reflects nursing's emergency prioritization, aligning with cardiac stability effectively.
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Nonstress test in a 36-week pregnancy is reported as reactive. What does the nurse anticipate should be required?
- A. The test has to be repeated for 20 minutes more
- B. An oxytocin drip will be initiated and the test repeated
- C. Reassurance can be offered
- D. The client has to be prepared for C-section
Correct Answer: C
Rationale: A reactive NST at 36 weeks means reassurance, not repeat testing, oxytocin, or C-section. Fetal heart accelerations show well-being no intervention needed, unlike nonreactive results. Leadership expects this imagine calm parents; it aligns with obstetric care effectively. This reflects nursing's role in fetal monitoring.
The nurse manager generally uses a stepwise method to arrive at decisions that are logical and that is used to maximize the achievement of the desired objective. Which decision-making model does this manager use?
- A. Political decision-making model
- B. Experimentation process
- C. Rational decision-making model
- D. Trial-and-error method
Correct Answer: C
Rationale: The rational decision-making model uses a stepwise, logical approach to maximize objectives, unlike political, experimentation, or trial-and-error. Nurse managers employing this like scheduling staff to reduce overtime analyze options systematically, contrasting with intuitive methods. This ensures decisions align with goals, such as patient safety or resource efficiency, critical in healthcare's structured environment. Leadership here emphasizes evidence over politics or guesswork, fostering trust and consistency in high-stakes settings where errors impact lives.
He likewise stresses the need for all the employees to follow orders and instructions from him and not from anyone else. Which of the following principles does he refer to?
- A. Scalar chain
- B. Discipline
- C. Unity of command
- D. Order
Correct Answer: C
Rationale: Unity of command, per Fayol, ensures employees follow one superior Joey avoiding confusion from multiple directives. Scalar chain is the authority line, discipline obedience, and order placement. In his unit, this clarity prevents conflicting orders, like on patient protocols, streamlining care. Joey's leadership enforces this to maintain control, critical in a tertiary hospital where precision impacts outcomes, aligning staff under his vision for efficiency and accountability.
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.
A nurse is planning care for several clients. Which of the following clients should the nurse refer to a case manager?
- A. A client who has neurological deficits following a stroke
- B. A client with a minor sprain
- C. A client with a resolved infection
- D. A client needing a one-time dressing change
Correct Answer: A
Rationale: Case managers coordinate complex, long-term care needs, making a client with neurological deficits post-stroke an ideal referral. Strokes often result in ongoing rehabilitation, therapy, and resource needs physical, occupational, or home health requiring sustained planning and cost management beyond acute care. A minor sprain, resolved infection, or one-time dressing change involves short-term, straightforward interventions, manageable by bedside staff without case management's scope. The stroke client's deficits demand interdisciplinary coordination, monitoring, and advocacy, aligning with the case manager's role to optimize recovery, reduce readmissions, and navigate healthcare systems, ensuring comprehensive support for a condition with lasting impact.