Nokea
In the Emergency Department (ED), which client should the nurse see first?
- A. COPD client with a non-productive cough
- B. Diabetic client who has an infected sore on the foot
- C. Client with adrenal insufficiency who feels weak
- D. Client with a fracture of the forearm in an air splint
Correct Answer: C
Rationale: In the Emergency Department, the priority is to assess and manage clients based on the urgency of their conditions. A client with adrenal insufficiency presenting with weakness should be seen first as this could indicate a state of shock, which requires immediate attention to stabilize the client's condition. Weakness in adrenal insufficiency can progress rapidly to a life-threatening adrenal crisis. Choice A, a COPD client with a non-productive cough, may need treatment but is not immediately life-threatening. Choice B, a diabetic client with an infected sore on the foot, requires timely care to prevent complications but can generally wait for evaluation compared to the potential urgency of adrenal insufficiency. Choice D, a client with a fracture of the forearm in an air splint, is important but not as time-sensitive as a client potentially in shock.
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The client with obsessive-compulsive disorder (OCD) is asking for help with the repetitive behaviors. The nurse knows that these are a method of dealing with:
- A. Fearful situations
- B. Depression
- C. Delusions
- D. Anxiety
Correct Answer: D
Rationale: The correct answer is D: Anxiety. Repetitive behaviors in OCD serve as a way for individuals to cope with their anxiety. These behaviors are often performed to reduce the distress caused by obsessive thoughts. Choice A, fearful situations, is incorrect because the behaviors are more related to managing anxiety rather than fear itself. Choice B, depression, is incorrect as OCD behaviors are not typically a method of coping with depression. Choice C, delusions, is also incorrect as these behaviors are not aimed at managing delusional thoughts but rather anxiety in OCD.
An RN on your unit has had an argument with the family of a client regarding the way in which the RN has changed the client's dressing. The family is adamant that the dressing change was performed incorrectly. The RN insists that sterile technique was observed. As an RN manager, what is the best response?
- A. Meet with the family member and the RN to discuss the disagreement regarding the dressing change.
- B. Talk to the family member and assure them that the nurse followed the hospital procedure.
- C. Discuss the dressing change procedure with the RN and compare it to a current textbook.
- D. Change the RN's assignment the next day to another client.
Correct Answer: A
Rationale: When conflict occurs, it is best to meet with both parties together to discuss the problem. This approach allows each party to hear what the other is saying and prevents the RN manager from being caught in the middle. By facilitating a discussion between the family member and the RN, they can work together to find a resolution or the manager can mediate. This promotes open communication, understanding, and collaboration. Option A is the correct choice because it emphasizes addressing the conflict directly and seeking a mutual understanding. Option B is incorrect because just assuring the family member may not address the underlying issues. Option C is incorrect as it does not involve the family member in the resolution process. Option D is inappropriate as it doesn't address the conflict but rather avoids it by changing the RN's assignment.
The nurse is caring for a preschool child who is being treated in the hospital for respiratory syncytial virus (RSV). In planning the client's care, the nurse should recognize that the child is likely to view this illness as?
- A. Punishment.
- B. Disturbance to body image.
- C. Rejection from parents.
- D. Change in routine with friends.
Correct Answer: A
Rationale: The correct answer is A: Punishment. Preschool children often see illness as a form of punishment, especially when they are unable to understand the cause of their sickness. This perception is rooted in their limited cognitive abilities and understanding of health concepts. Choices B, C, and D are incorrect because preschool children are less likely to associate illness with disturbance to body image, rejection from parents, or changes in routine with friends. These options are not developmentally appropriate for how preschoolers typically interpret illness.
The power a healthcare professional exerts when working to accomplish goals and effect change in an agency or policy is considered what type of power?
- A. political
- B. personal
- C. positional
- D. professional
Correct Answer: A
Rationale: Political power is the correct answer in this scenario. It stems from the ability to navigate systems, agencies, or policies to bring about change. Personal power is related to charisma and self-confidence in informal leadership roles. Positional power comes from holding a specific authority in a formal position. Professional power is derived from expertise in a particular area of practice. Therefore, in the context of effecting change in an agency or policy, political power is the most relevant type of power.
The nurse overhears two nursing students talking about a client in the cafeteria. What should the nurse do first?
- A. Report the incident to the nursing supervisor.
- B. Write up a variance report about the incident.
- C. Instruct the students that this is a violation of HIPAA.
- D. Notify the students' faculty regarding the violation.
Correct Answer: C
Rationale: The correct answer is to instruct the students that discussing a client in a public area like the cafeteria violates HIPAA regulations. This is important to educate the students about patient confidentiality and the consequences of breaching it. Reporting to the nursing supervisor or faculty should come after addressing the students directly. Writing up a variance report is not the immediate action needed in this situation, as educating the students about their mistake should be the priority. It is essential to address the issue at the source by educating the students first rather than escalating the matter to supervisors or faculty immediately.