Mr. W has orders for a physical therapy consult. The nurse contacts the appropriate department but 12 hours later, no one has come to see the client. Which is the most appropriate action of the nurse?
- A. Call the supervisor and file a complaint against the physical therapy department
- B. Contact the physician to notify him that the orders were not carried out
- C. Assess the client's activity level by assisting with ambulation using a gait belt
- D. Contact the physical therapy department again and repeat the order
Correct Answer: D
Rationale: The most appropriate action for the nurse in this scenario is to contact the physical therapy department again and repeat the order (Choice D). This is the correct answer because it directly addresses the issue of the consult not being completed within a reasonable timeframe. By contacting the department again, the nurse ensures that the order is not overlooked or forgotten. This action shows proactive communication and follow-up to expedite the process and ensure the client receives the necessary care in a timely manner.
The other choices are incorrect:
A: Calling the supervisor and filing a complaint is premature without first attempting to resolve the issue directly with the department.
B: Contacting the physician is not the nurse's role in this situation. The focus should be on coordinating with the appropriate department.
C: Assessing the client's activity level is important but does not address the primary issue of the physical therapy consult not being completed.
Overall, choice D is the most appropriate course of action in this scenario.
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The discharge planning team is discussing plans for the dismissal of a 16-year-old admitted for complications associated with asthma. The client's mother has not participated in any of the discharge planning processes but has stated that she wants to be involved. Which of the following reasons might prohibit this mother from participating in discharge planning?
- A. The client is an emancipated minor
- B. The mother has to work and is unavailable
- C. The client has a job and a driver's license
- D. The mother does not speak English
Correct Answer: A
Rationale: The correct answer is A: The client is an emancipated minor. Emancipated minors are legally considered adults and have the right to make their own medical decisions without parental involvement. In this case, since the 16-year-old is emancipated, the mother's participation in discharge planning may be prohibited.
Choice B is incorrect because the mother's work schedule does not necessarily prohibit her from participating in discharge planning. Choice C is irrelevant as the client having a job and a driver's license does not impact the mother's ability to participate. Choice D, the mother not speaking English, may present a communication barrier but does not inherently prohibit her from participating.
A patient diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Treatment most likely provided by the center includes
- A. Medical management of symptoms
- B. Daily psychotherapy
- C. Constant staff supervision
- D. Psychological stabilization
Correct Answer: A
Rationale: The correct answer is A: Medical management of symptoms. In mild anxiety disorders, medication like SSRIs or benzodiazepines are commonly used to alleviate symptoms. Psychotherapy may be helpful but is not daily. Constant staff supervision is not necessary for mild cases. Psychological stabilization is too broad and not specific to treatment.
A nurse is caring for a dying client whose family wants to be with him in the operating suite. The surgeon, however, does not allow families to be present during surgery. The nurse recognizes this as an ethical dilemma. What is the initial step of the nurse when managing this situation?
- A. Contact the physician to amend the order for the client
- B. Document an account of the situation to ensure adequate coverage of details
- C. Consult with the medical ethics committee to determine a safe and workable solution
- D. Speak with the chief nursing officer to change the policy governing this situation
Correct Answer: A
Rationale: The correct initial step is to choose option A: Contact the physician to amend the order for the client. This is the most appropriate action because the conflict arises from the surgeon's policy, which can potentially be changed with physician involvement. By discussing the situation with the physician, the nurse can advocate for the family's wishes and potentially negotiate a compromise. This step prioritizes the client's and family's needs while also respecting the surgeon's authority. Options B, C, and D are not the initial steps because they involve escalating the situation before attempting direct communication with the physician, which can be seen as bypassing the appropriate chain of command.
A nursing unit is implementing a new electronic charting program for the nursing staff to use. Which of the following best describes a disadvantage of using electronic charting?
- A. The information is more likely to be lost or used inappropriately.
- B. Any provider in the unit can have access to the client's medical records.
- C. The system diminishes communication between nurses and providers.
- D. The program may be confusing and difficult to implement.
Correct Answer: D
Rationale: The correct answer is D: The program may be confusing and difficult to implement. Implementing a new electronic charting program may be challenging due to the complexity of the software and the learning curve for staff. It can take time and resources to train employees on how to effectively use the program, leading to potential confusion and resistance to change. This disadvantage could result in delays in charting, errors, and frustrations among staff members.
Other choices are incorrect because:
A: The information is more likely to be lost or used inappropriately - Electronic charting systems often have built-in security measures to prevent data loss and unauthorized access.
B: Any provider in the unit can have access to the client's medical records - Electronic charting systems have role-based access control to limit who can view specific patient information.
C: The system diminishes communication between nurses and providers - Electronic charting can actually improve communication by allowing real-time access to patient information.
The nurse is assessing an infant with developmental dysplasia of the hip. Which finding would the nurse anticipate?
- A. Unequal leg length
- B. Limited adduction
- C. Diminished femoral pulses
- D. Symmetrical gluteal folds
Correct Answer: A
Rationale: The correct answer is A: Unequal leg length. In developmental dysplasia of the hip, there is abnormal development of the hip joint. This can lead to unequal leg lengths due to hip instability and dislocation. Limited adduction may be present due to hip joint abnormalities. Diminished femoral pulses are not typically associated with developmental dysplasia of the hip. Symmetrical gluteal folds are usually present in healthy infants.
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