Nokea
Many nursing professionals have portfolios that include:
- A. family pictures.
- B. letters of commendation.
- C. articles that describe lack of quality in health care.
- D. high school achievements.
Correct Answer: B
Rationale: The correct answer is B: letters of commendation. Nursing professionals typically include letters of commendation in their portfolios to showcase their achievements, skills, and positive feedback from colleagues or supervisors. This demonstrates their competence and professionalism. Family pictures (A) and high school achievements (D) are not relevant to a nursing portfolio. Articles describing lack of quality in healthcare (C) could reflect negatively on the professional and are not typically included in a portfolio meant to highlight accomplishments.
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An interdisciplinary team is evaluating the hospital's care of patients admitted with a myocardial infarction (heart attack) compared to national standards. The team analyzes the hospital's clinical indicator, which would be: (select all that apply)
- A. aspirin order within 24 hours of discharge.
- B. patient teaching related to stopping smoking completed prior to discharge.
- C. beta blocker administered upon arrival.
- D. support of employer to modify stress in workplace.
Correct Answer: A
Rationale: The correct answer is A: aspirin order within 24 hours of discharge. This is a key clinical indicator for evaluating care of heart attack patients as aspirin is a standard treatment to prevent further cardiac events. It is crucial for patient safety and adherence to national guidelines.
Choice B is incorrect as patient teaching on smoking cessation, although important, is not a direct clinical indicator for evaluating care of heart attack patients.
Choice C is incorrect as beta blocker administration upon arrival is important for heart attack patients, but it is not specific to evaluating the hospital's care compared to national standards.
Choice D is incorrect as employer support for stress modification is not a clinical indicator relevant to evaluating care of heart attack patients.
Which functions can be delegated only to another RN with appropriate experience and training? (select all that apply)
- A. Assessment of skin integrity on third day of hospitalization
- B. Evaluation of patient teaching related to turn, cough, and deep breathing exercises
- C. Nursing judgment related to withholding medication based on vital signs
- D. RNs do not delegate to other RNs, they delegate only to licensed practical nurses or unlicensed assistive personnel
Correct Answer: C
Rationale: The correct answer is C because nursing judgment related to withholding medication based on vital signs requires critical thinking, clinical knowledge, and experience. This decision-making process involves assessing the patient's condition, interpreting vital signs, and determining if medication should be given or withheld to ensure patient safety. This function cannot be delegated to someone without the appropriate training and expertise.
A: Assessment of skin integrity on the third day of hospitalization can be delegated to other healthcare team members such as LPNs or nursing assistants, as long as they have been trained and deemed competent.
B: Evaluation of patient teaching related to turn, cough, and deep breathing exercises can be delegated to other healthcare team members, as long as they have the appropriate training and supervision.
D: The statement that RNs do not delegate to other RNs is incorrect. RNs can delegate certain tasks to other RNs based on their scope of practice and level of experience. It is not limited to LPNs or unlicensed assistive personnel.
An RN delegates to the unlicensed assistive personnel (UAP) the task of performing blood pressure checks for a group of patients on a nursing unit. The UAP accepts the task and is responsible for:
- A. delegating the task to another UAP if he or she does not have the time or skill to complete the task.
- B. keeping the RN informed of any abnormal blood pressure readings.
- C. calling the physician when the patient's vital signs are not within established parameters.
- D. informing the dietary department to initiate a low-sodium diet for patients who are hypertensive.
Correct Answer: B
Rationale: The correct answer is B because keeping the RN informed of any abnormal blood pressure readings is an essential part of the UAP's responsibility. This ensures that the RN is aware of any potential issues with the patients' health and can intervene if necessary. It is important for the UAP to communicate such vital information promptly to the RN, who has the clinical expertise to assess the situation and make appropriate decisions.
Choice A is incorrect because the UAP should not delegate tasks to another UAP without prior authorization from the RN. Choice C is incorrect because calling the physician directly is beyond the scope of practice for a UAP. Choice D is incorrect because initiating a low-sodium diet for hypertensive patients is a clinical decision that should be made by the RN or physician, not the UAP.
A nurse is having difficulty managing assignments at work, which results in a feeling of "failure" and tasks that are not completed or that are not completed satisfactorily. The mentor suggests some tips for time management. These include: (select all that apply)
- A. focusing on activities to be completed, rather than on objectives.
- B. planning for tomorrow today.
- C. making certain that the last hours are the most productive in tying up loose ends.
- D. maintaining a log of how the nurse spends time (no need to worry about using complete sentences).
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. Planning for tomorrow today allows the nurse to set clear goals and prioritize tasks in advance.
2. By planning ahead, the nurse can allocate time efficiently, reducing the feeling of overwhelm.
3. This approach fosters better organization and focus, enhancing productivity and task completion.
4. Planning helps in identifying potential obstacles and developing strategies to overcome them.
5. Ultimately, effective planning leads to better time management and a sense of accomplishment.
Summary of why other choices are incorrect:
A: Focusing on activities rather than objectives can lead to a lack of direction and prioritization.
C: Making the last hours most productive neglects the importance of consistent time management throughout the day.
D: Maintaining a log of time spent can be helpful but does not address the proactive approach of planning ahead for better time management.
A priority action for the nurse who works with culturally diverse clients is completion of a:
- A. sign language course.
- B. cultural self-assessment.
- C. cultural client assessment.
- D. continuing education course on how to speak Spanish.
Correct Answer: B
Rationale: The correct answer is B: cultural self-assessment. This is important as it helps the nurse understand their own beliefs, values, and biases, which can impact how they interact with culturally diverse clients. By being self-aware, the nurse can better recognize and address any potential cultural misunderstandings or conflicts.
A: Taking a sign language course is not the priority as not all culturally diverse clients are deaf or use sign language.
C: While cultural client assessment is important, it is secondary to the nurse understanding their own cultural biases first.
D: Taking a course on how to speak Spanish is helpful but may not address the broader cultural competence needed to work with diverse clients.