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The charge nurse needs to determine if an additional nurse should be called to help staff the unit for the next shift. Which information is most important for the charge nurse to consider when making this decision?
- A. The number of clients leaving the unit for diagnostic tests.
- B. The acuity level of the clients on the unit.
- C. The physician's plans to perform procedures on the unit.
- D. The skill level of the personnel staffing the unit.
Correct Answer: B
Rationale: Client acuity determines the intensity of care needed, critical for staffing decisions.
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A group of nurse managers is asked to engage in a needs assessment for a piece of equipment that will be expensed to the organization's budget. Which question is most important to consider when analyzing the cost-benefit for this piece of equipment?
- A. How many departments can use this equipment?
- B. Can the equipment be updated each year?
- C. Is the cost of equipment reasonable?
- D. Will the equipment require annual repair?
Correct Answer: C
Rationale: Determining if the cost is reasonable directly evaluates the equipment's value against its benefits, critical for budget decisions.
When making assignments for residents of a long-term care facility who require assistance with feeding, which client should the charge nurse assign to the practical nurse (PN) rather than the unlicensed assistive personnel (UAP)?
- A. An elderly woman who refuses to eat most meals served.
- B. A disabled client who is learning to use adaptive equipment.
- C. A client who drools but swallows solids after many attempts.
- D. An older, edentulous client who has loose fitting dentures.
Correct Answer: A
Rationale: The client refusing meals requires a PN's assessment to address potential psychological or physiological issues.
The charge nurse is making assignments for a 15-bed skilled nursing unit with the staff of one nurse, two practical nurses (PN), and two unlicensed assistive personnel (UAP). Which client should be assigned to the PN?
- A. The client who had bilateral above-knee amputations, now has a sacral decubitus skin flap, and is receiving vancomycin intravenously.
- B. The client who is in end-stage Alzheimer's, who requires feeding, and is waiting for a long-term facility placement.
- C. The client who has pneumonia following a total knee replacement, and is receiving clarithromycin orally.
- D. The client who has right hemiplegia as the result of a cerebral vascular accident and receives continuous gastrostomy feedings per enteral pump.
Correct Answer: C
Rationale: The pneumonia client with oral medication is stable and within the PN's scope.
A fire is reported in the kitchen on the first floor of a three-floor community hospital, and the operator notifies the charge nurse on the third floor to start evacuation procedures. Which intervention should the charge nurse implement?
- A. Instruct the nursing staff to evacuate ambulatory clients to the nearest fire exits.
- B. Instruct unlicensed assistive personnel (UAPs) to transfer all non-ambulatory clients via wheelchairs.
- C. Announce in a calm voice that all visitors should proceed immediately to the first floor via the service elevators.
- D. Shut all doors to client rooms and tell everyone to stay in their rooms until the fire department arrives.
Correct Answer: A
Rationale: Evacuating ambulatory clients to fire exits prioritizes their safety, following standard fire evacuation protocols.
An older adult woman with end stage heart disease is alert and oriented and states that she does not want any heroic measures taken in the event she stops breathing. The client's children tell the nurse that they accept their mother's wishes and do not want to watch her suffer. Which action should the nurse take first?
- A. Consult the palliative care team.
- B. Obtain a do not resuscitate prescription.
- C. Define the term heroic measures.
- D. Coordinate a family conference.
Correct Answer: B
Rationale: Obtaining a DNR prescription legally documents the client's wishes, a priority action.