Nokea
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.
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The receiver is also referred to as the
- A. Active listener
- B. Encoder
- C. Decoder
- D. Transmitter
Correct Answer: C
Rationale: Receiver is decoder , not listener, encoder, or transmitter. Nurse leaders like staff interpreting rely on this, contrasting with sending. In healthcare, understanding completes the loop, aligning leadership with reception.
The nurse is preparing to administer a dose of amoxicillin to a client with a urinary tract infection. Which laboratory value should the nurse review prior to administration?
- A. Serum creatinine
- B. White blood cell count
- C. Blood glucose
- D. Potassium
Correct Answer: A
Rationale: Before amoxicillin for a UTI, review serum creatinine, not WBC, glucose, or potassium. Penicillins are renally cleared creatinine flags kidney function, guiding dosing. Others track infection or unrelated issues. Leadership checks this imagine oliguria; it prevents toxicity, aligning with antibiotic care effectively.
A nurse is caring for a client who is postoperative following abdominal surgery and has a nasogastric (NG) tube to low intermittent suction. Which of the following findings should the nurse report to the provider?
- A. Absence of bowel sounds
- B. NG tube output of 200 mL in 4 hours
- C. Abdominal distension
- D. Gastric residual of 50 mL
Correct Answer: A
Rationale: Post-abdominal surgery, an NG tube to low intermittent suction decompresses the stomach, aiding recovery. Absence of bowel sounds indicates ileus paralysis of intestinal motility a potential complication like obstruction or peritonitis, requiring provider notification for imaging or intervention. NG output of 200 mL in 4 hours (50 mL/hr) is expected, removing fluid or gas, while distension may occur but isn't urgent unless worsening with other signs. Gastric residual of 50 mL is minimal, not concerning with suction. Absent bowel sounds signal a critical deviation, demanding prompt reporting to prevent escalation, reflecting the nurse's role in vigilant postoperative monitoring.
The nurse is applying a decision-making process to a clinical challenge. When applying this process, the nurse must:
- A. analyze the root causes of a situation
- B. begin by solving the underlying problem
- C. choose between different courses of action
- D. prioritize the maximum good for the maximum number of people
Correct Answer: C
Rationale: In nursing, decision making involves selecting a course of action, as this nurse must do amidst a clinical challenge. Analyzing root causes or solving problems first are steps within problem solving a systematic subset of decision making but the core act is choosing, like opting for one treatment over another. Prioritizing the maximum good aligns with utilitarian ethics, but nursing often lacks the scope for such broad impact in single decisions. For instance, faced with a patient's deteriorating vitals, the nurse chooses between immediate intervention or monitoring, weighing options based on data and protocols. This choice-driven process, distinct from exhaustive analysis, empowers nurses to act decisively in dynamic settings, ensuring patient safety and care quality, a critical leadership skill in managing clinical uncertainties effectively.
As part of a staff recognition program, the chief nursing officer decides that staff who demonstrate exceptional professional commitment will be recognized with a monetary award and a letter from the CNO. The outcome that the CNO wishes to achieve through this recognition program is:
- A. Increased professional accountability
- B. Increased staff retention
- C. Increased collaboration among staff
- D. Evidence of support for collective bargaining
Correct Answer: B
Rationale: The CNO's awards for commitment money and praise aim to boost staff retention, reinforcing loyalty to the organization's mission. Committed nurses stay, reducing turnover, a key goal in healthcare's staffing crisis. It's not directly about accountability, collaboration, or bargaining support, though it may foster those. Recognition ties effort to staying, as studies show appreciation cuts nurse exodus, aligning with the CNO's intent to keep dedicated talent.