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The healthcare provider prescribes an oral medication to be given daily for 3 days. However, the medication was also given on the fourth day. Which intervention is most important for the charge nurse to implement?
- A. Inform the pharmacist who dispensed the medication.
- B. Evaluate the client for symptoms of a drug overdose.
- C. Report the medication error to the nursing supervisor.
- D. Review the medication transcription with the nurse.
Correct Answer: B
Rationale: Evaluating for overdose symptoms ensures client safety, addressing potential harm from the error. Informing the pharmacist, reporting, and reviewing transcription are secondary actions.
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Several nurses are elected by their peers to serve on a negotiating committee to recommend new healthcare benefits. After the new benefits plan is developed and approved, which action is most important for the nurses working on this committee to implement?
- A. Announce the new plan at a special employee wellness event.
- B. Determine staff opinion of current healthcare insurance costs.
- C. Survey the nurses to see who wants to keep the old benefits plan.
- D. Be available to all shifts to discuss the changes in health benefits.
Correct Answer: D
Rationale: Being available to discuss changes ensures clear communication and addresses concerns across all shifts, fostering acceptance. Announcing at an event, assessing current costs, or surveying preferences are less critical post-approval.
The nurse leading a care team on a medical surgical unit is assigning client care to a practical nurse (PN) and an unlicensed assistive personnel (UAP). Which task should the nurse delegate to the PN?
- A. Begin initial sterile wound care for surgical clients.
- B. Validate prescribed intravenous flow rates.
- C. Determine the need for urinary catheterizations.
- D. Receive a postoperative client and conduct the assessment.
Correct Answer: B
Rationale: Validating IV flow rates is within the PN's scope, involving routine checks of orders and drip rates. Initial wound care, assessing catheter need, and postoperative assessments require RN clinical judgment.
Four clients are scheduled to receive IV infusions, but there are only three intravenous (IV) pumps available. Which prescribed infusion can most safely be administered without an IV infusion pump?
- A. Ceftriaxone in 5% Dextrose in Water prescribed for pneumonia.
- B. Heparin in Normal Saline prescribed for deep vein thrombosis.
- C. Magnesium in Normal Saline prescribed for hypomagnesemia.
- D. Regular insulin in Normal Saline prescribed for ketoacidosis.
Correct Answer: A
Rationale: Ceftriaxone can be safely administered by gravity infusion with nurse monitoring, as its dosing is less sensitive to minor flow rate variations. Heparin, magnesium, and insulin require precise infusion rates due to risks of bleeding, toxicity, or glucose imbalances, necessitating an IV pump.
In evaluating a staff nurse who demonstrates inconsistent performance, which intervention should the nurse- manager employ?
- A. Evaluate the nurse's performance using standards of practice, citing both strengths and weaknesses with emphasis on ways to improve practice.
- B. Focus on the strengths of the staff nurse; discuss any weaknesses verbally but avoid documenting the nurse's negative behaviors.
- C. Emphasize the nurse's areas of weakness in light of the inconsistent performance observed and discuss how to improve in each of these areas.
- D. Focus on a discussion of how the inconsistency in the staff nurse's performance disrupts the routine of all of the staff members on the unit.
Correct Answer: A
Rationale: Evaluating using standards provides objective feedback, balancing strengths and weaknesses to guide improvement. Focusing only on strengths or weaknesses, or discussing team disruption, may demotivate or fail to address performance issues effectively.
The charge nurse in an emergency center is planning client care assignments for the staff. Which action may be safely delegated to the practical nurse (PN)?
- A. Provide client with resources and discharge teaching
- B. Educate the clients about prescribed dietary changes.
- C. Establish blood pressure parameters for client monitoring
- D. Reinforce diet teaching for discharge to home
Correct Answer: D
Rationale: Reinforcing diet teaching is within the PN's scope, reviewing prior RN education. Providing resources, educating on diet changes, and setting BP parameters require RN judgment.