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If the nurse and nurse manager did not resolve the situation related to the physician's report about the nurse's performance, what is the length of time allowed for the nurse to submit an appeal?
- A. 10 days
- B. 15 days
- C. 20 days
- D. 30 days
Correct Answer: A
Rationale: If the informal discussion between the nurse and nurse manager does not resolve the issue regarding the physician's report on the nurse's performance, the nurse can submit a written appeal within 10 days, according to the health care facility policy. This 10-day timeframe ensures a prompt resolution of disputes and maintains clear communication channels within the healthcare setting. Choices B, C, and D are incorrect as they exceed the time limit allowed for the nurse to submit an appeal, which is specified to be 10 days.
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Why is increasing the use of advanced practice nurses encouraged?
- A. A 2010 Institute of Medicine report recommended nurses practice to the full extent of their education.
- B. Advanced practice nurses act as an extension of physicians.
- C. The National League for Nursing advocates for the master of science in nursing (MSN) as the terminal degree for nurse practitioners.
- D. Advanced practice nurses lack the skills to diagnose.
Correct Answer: A
Rationale: The correct answer is A because the 2010 Institute of Medicine report recommended that nurses practice to the full extent of their education, which includes utilizing advanced practice nurses. This supports the efficient delivery of healthcare services. Choice B is incorrect as it focuses on the relationship between advanced practice nurses and physicians rather than a reason for increasing their use. Choice C is not a direct reason for increasing the use of advanced practice nurses but rather a statement about the terminal degree for nurse practitioners. Choice D is incorrect as advanced practice nurses do possess the skills necessary to diagnose and provide advanced care.
Which patient action indicates a good understanding of the nurse’s teaching about the use of
an insulin pump?
- A. The patient programs the pump for an insulin bolus after eating
- B. The patient changes the location of the insertion site every week
- C. The patient takes the pump off at bedtime and starts it again each morning.
- D. The patient plans for a diet that is less flexible when using the insulin pump.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is receiving pain medication through a PCA pump. Which of the following actions should the nurse take?
- A. Educate the family not to push the button for the client while the client is asleep.
- B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
- C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
- D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.
Correct Answer: D
Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.
A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?
- A. "I had a bowel movement, but I was able to save the urine."
- B. "I have a specimen in the bathroom from about 30 minutes ago."
- C. "I drink a lot, so I will fill up the bottle and complete the test quickly."
- D. "I flushed what I urinated at 7:00 a.m. and have saved all urine since."
Correct Answer: C
Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.
When should a critical pathway be revised?
- A. When it becomes too long.
- B. When the variances show a new trend.
- C. When a member of the team retires.
- D. When the client leaves the hospital.
Correct Answer: B
Rationale: A critical pathway should be revised when variances in the patient's progress indicate a new trend or deviation from the expected course of treatment. This allows healthcare providers to adjust the pathway to ensure optimal patient care and outcomes. Changes in the critical pathway are not typically driven by its length or external factors like team member retirements or client discharges. Therefore, the correct answer is B. Choice A is incorrect because the length of the critical pathway alone does not determine the need for revision. Choices C and D are irrelevant to the patient's progress and treatment plan, making them incorrect.