Nokea
The nurse cares for an elderly patient in a long-term care center. Which would be inappropriate for the nurse to share with the client?
- A. Reminisce about birthday celebrations and inquire about the client's traditions.
- B. Use high levels of intimacy to help the client feel more comfortable with the nurse.
- C. Establish a helping relationship based on trust by sharing a personal story with the client.
- D. Share with the client how meditation decreased nausea during chemotherapy treatment.
Correct Answer: B
Rationale: The correct answer is B because using high levels of intimacy with a client, especially in a professional setting like a long-term care center, can violate boundaries and be inappropriate. The nurse should maintain a professional and therapeutic relationship with the client. Reminiscing about birthday celebrations (A) can help establish rapport and show interest in the client's life. Sharing personal stories (C) can build trust and connection. Sharing a relevant experience about meditation (D) can provide valuable information and support. In summary, maintaining appropriate boundaries and professionalism is crucial in a nurse-client relationship.
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When using the telephone to communicate with a primary care provider about a patient, the student nurse should have ready: (Select all that apply.)
- A. current information relative to patient's condition change.
- B. assessment of vital signs.
- C. information on urinary output.
- D. patient's social security number or hospital identification number.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Current information on patient's condition change is crucial for effective communication with the primary care provider.
2. This allows the student nurse to provide accurate and up-to-date information for appropriate decision-making.
3. Assessment of vital signs or information on urinary output may be important, but the question specifically focuses on communication about the patient's condition change.
4. Patient's social security number or hospital identification number is not necessary for communicating about the patient's condition change.
In summary, choice A is correct as it ensures accurate communication, while the other choices are not directly related to communicating patient's condition change.
The nurse prepares to obtain a health history from a hospitalized patient. Which action by the nurse is appropriate?
- A. Set time limits for the interview to reduce cost.
- B. Avoid asking questions that may upset the patient.
- C. Respect the patient's privacy by closing the door.
- D. Stand at the foot of the bed to maintain eye contact.
Correct Answer: C
Rationale: The correct answer is C: Respect the patient's privacy by closing the door. Closing the door ensures confidentiality and privacy during the health history interview, promoting trust between the nurse and patient. This setting allows for open communication and prevents distractions. Options A and D are incorrect because setting time limits for the interview to reduce cost and standing at the foot of the bed to maintain eye contact do not prioritize patient privacy and comfort. Option B is incorrect because avoiding questions that may upset the patient may hinder the nurse's ability to gather important information for proper care.
There are 2 hours left before the shift ends. The new UAP tells the team leader that she must leave now because she has a family emergency. What should the team leader do? Select all that apply.
- A. Ask her what tasks and duties are pending for the next 2 hours.
- B. Call a UAP who is scheduled for the next shift to come early.
- C. Allow her to leave but remind her she is still on probation as a new staff member.
- D. Call another unit and see if there is a UAP who could float to the unit.
Correct Answer: A
Rationale: The correct answer is A. The team leader should ask the UAP what tasks and duties are pending for the next 2 hours to assess the workload and determine if it's possible for the UAP to leave immediately. By understanding the pending tasks, the team leader can make an informed decision on whether the UAP leaving will impact patient care or workload. This approach ensures that patient care is not compromised and that the team's responsibilities are managed effectively.
Choices B, C, and D are incorrect because they do not directly address the immediate situation of the UAP needing to leave due to a family emergency. Calling another UAP, reminding the UAP of probation status, or seeking assistance from another unit may not be necessary or relevant if the tasks can be managed effectively without the UAP who needs to leave. These options do not prioritize understanding the pending tasks and duties to make an informed decision.
The team leader is reviewing the pain management plan for Mr. U. He is having significant pain related to the cancer and the pulmonary resection. Which option would be the best for Mr. U?
- A. Mr. U is instructed to ask for pain medication whenever he needs it.
- B. Mr. U is to receive around-the-clock fixed doses of opioid analgesics.
- C. Mr. U should be offered the nonopioid medication first to see it if works.
- D. Mr. U has a high risk for respiratory distress, so opioids are not prescribed.
Correct Answer: B
Rationale: The correct answer is B because Mr. U is experiencing significant pain related to cancer and pulmonary resection, which typically requires continuous pain management. Around-the-clock fixed doses of opioid analgesics provide consistent pain relief and can be adjusted based on his pain levels. This approach ensures adequate pain control without the need for Mr. U to wait until the pain becomes severe before asking for medication. Option A may lead to undertreatment of pain. Option C delays effective pain relief for Mr. U who is already experiencing significant pain. Option D is incorrect as opioids can be safely administered with proper monitoring, even in patients at high risk for respiratory distress.
The primary care provider informs the student nurse that he would like to give a telephone order. The best response by the student is:
- A. document the telephone order on the primary care provider's orders.
- B. ask another student to listen as a witness to the telephone order.
- C. tape record the primary care provider giving the order to the student nurse.
- D. ask the registered nurse to take the telephone order.
Correct Answer: D
Rationale: The correct answer is D because asking the registered nurse to take the telephone order ensures accuracy and accountability. The registered nurse is trained to accurately transcribe orders and can verify the details with the primary care provider if needed. This also follows the chain of command and delegation principles in healthcare.
Choice A is incorrect because the student nurse should not document the order directly without proper verification. Choice B is incorrect as having another student as a witness does not guarantee accuracy or proper documentation. Choice C is incorrect as recording the order could violate patient privacy laws and does not involve a healthcare professional in the transcription process.