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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You have recently been appointed as a unit manager. After 3 months, you notice that staff are not seeking your advice as frequently as they did during your first weeks as manager. This observation may suggest that:
- A. Staff no longer perceive you as an expert
- B. Staff have increasing confidence in their own decision making
- C. There has been erosion in your relationships with staff
- D. Staff are experiencing dissatisfaction with your leadership
Correct Answer: B
Rationale: Staff seeking less advice after three months likely signals growing confidence in their own decisions, a natural shift as they adjust to your leadership and rely on their skills. It's not necessarily expertise loss, eroded ties, or dissatisfaction context matters, but reduced dependence often marks autonomy, a positive outcome in a stable unit. New managers see this as staff adapt, suggesting your initial support built their competence, aligning with effective leadership fostering independence over time.
A nurse is preparing to attend a care plan conference for a client who has severe burns. Which of the following criteria should the nurse identify as part of an effective conference?
- A. The nurse leads all discussions
- B. Other health care professionals are in attendance at the conference
- C. The client is excluded from planning
- D. Only nursing goals are set
Correct Answer: B
Rationale: An effective care plan conference for a severe burns client requires interdisciplinary input due to the condition's complexity skin integrity, infection risk, mobility, nutrition, and psychological impact. Identifying that other healthcare professionals (e.g., physical therapists, dieticians, psychologists) attend ensures diverse expertise shapes a comprehensive plan, setting realistic, client-centered goals for recovery. The nurse leading all discussions limits collaboration, while excluding the client ignores their input and autonomy, reducing efficacy. Focusing only on nursing goals neglects broader needs like rehabilitation or dietary support. Multidisciplinary attendance fosters holistic planning, leverages specialized knowledge, and enhances outcomes, aligning with best practices for complex cases like burns, where teamwork drives success.
As a member of a hospital committee, you advocate for a policy that allows staff nurses to request additional staffing during unexpected increases in patient acuity. Your advocacy reflects concerns about:
- A. Staff satisfaction
- B. Patient safety
- C. Cost containment
- D. Staff authority
Correct Answer: B
Rationale: Pushing for staffing boosts during acuity spikes like a trauma surge prioritizes patient safety, ensuring care matches need, cutting risks like errors or delays. Satisfaction may rise, costs shift, and authority isn't the focus safety is. On the committee, you address workload stress, as in fall or error trends, aligning with nursing's duty to protect patients, a proactive policy to maintain quality under pressure.
You are charged with developing a new nursing curriculum and are committed to developing a curriculum that reflects the needs of the profession and of the workplace. To address deficits that may already be present in nursing curricula related to the workplace, you include more content and skills development related to:
- A. therapeutic communication with patients
- B. effective communication in the workplace
- C. increased emphasis on sender-receiver dyads
- D. generational differences in communication
Correct Answer: B
Rationale: Nursing curricula often emphasize patient-focused therapeutic communication, but workplace dynamics like team conflicts demand effective communication skills among colleagues. Your curriculum shift addresses this gap, vital for team cohesion and care delivery, as seen in staff disputes. Sender-receiver focus or generational differences are subsets, not the core need. Workplace communication equips nurses to navigate professional relationships, enhancing collaboration and reducing friction, aligning with profession and workplace realities.
Nurse receives four phone calls from pregnant women in their last trimester of pregnancy. Which call should be answered first?
- A. Client can't sleep supine because shortness of breath
- B. Client with frequent heartburn
- C. Client who can't remove wedding ring
- D. Client with frequent non-painful uterine contractions
Correct Answer: A
Rationale: The nurse must prioritize the client with shortness of breath when supine, a potential sign of late-pregnancy complications like preeclampsia or heart strain, over heartburn, ring tightness, or non-painful contractions. Dyspnea signals respiratory or cardiac distress say, from fluid overload needing urgent assessment to prevent maternal-fetal harm. Heartburn's common, ring issues suggest edema (less acute), and contractions could be Braxton Hicks, not immediate labor. In nursing leadership, triaging this call first ensures safety; a delay might miss hypoxia, risking oxygen delivery to the fetus. Picture a 38-week pregnant woman gasping this demands swift action, guiding care prioritization in high-stakes obstetric settings effectively.