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The nurse cares for an infant undergoing a surgical repair of a total anomalous pulmonary venous return tomorrow. The doctor has talked to the parents and obtained consent. The mother tells the nurse, 'I'm not so sure about this. What if my baby dies?' The nurse's most appropriate response is:
- A. Explain the procedure to the mother.
- B. Notify the surgical team and have them come back to speak with the mother again.
- C. Reassure the mother that everything will go as planned.
- D. Tell the mother that because she has already signed the consent, she cannot change her mind now.
Correct Answer: B
Rationale: Notifying the surgical team (B) ensures the mother’s concerns are addressed by the provider, respecting her need for clarification. Explaining the procedure (A) is the physician’s role, false reassurance (C) is inappropriate, and stating consent is irrevocable (D) is incorrect and dismissive.
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The nurse is planning client assignments for a licensed practical/vocational nurse (LPN/VN). Which client assignment would be appropriate? A client
- A. in an arm cast who is suspected to have compartment syndrome.
- B. immediately post-operative from a prostate resection reporting bladder spasms.
- C. with a paralytic ileus requiring the insertion of a nasogastric tube.
- D. newly diagnosed with Hepatitis A and requires discharge teaching.
Correct Answer: B, D
Rationale: LPNs can manage stable clients with bladder spasms post-prostate resection (B) and provide discharge teaching for Hepatitis A (D), within their scope. Compartment syndrome (A) requires RN assessment for urgent intervention, and NG tube insertion (C) is typically an RN task due to complexity.
The nurse manager has been made aware of the following staff nurse issues. The manager should initially follow up on the staff nurse who
- A. falsified documentation on a client discharged within the last 24 hours.
- B. needs assistance completing an incident report about a medication administration error on the previous shift.
- C. was thirty minutes late and tardy to their shift and is not wearing the correct gown uniform.
- D. is suspected of alcohol impairment and is precepting a newly hired nurse.
Correct Answer: D
Rationale: Suspected alcohol impairment while precepting (C) poses an immediate safety risk to clients and staff, requiring immediate immediate manager intervention. Falsified documentation (D), incident report assistance (A), and tardiness/uniform issues (B) are serious but less urgent than impairment.
A mental health clinic is being constructed in a local community. A nurse manager is hired to facilitate the unit’s nursing policies. Which of the following is the best resource for these policies?
- A. Code of Ethics
- B. Nurse Practice Act
- C. Patient’s Bill of Rights
- D. Rights for the Mentally Ill
Correct Answer: B
Rationale: The Nurse Practice Act (B) defines legal scope and standards for nursing practice, making it the best resource for policy development. Code of Ethics (A), Patient’s Bill of Rights (C), and Rights for the Mentally Ill (D) guide but lack specific operational details.
The nurse is researching evidence-based practice and needs related literature. The nurse understands that the best source of reliable writing is:
- A. Systematic review and meta-analysis studies
- B. Expert opinions
- C. Qualitative studies
- D. Case studies
Correct Answer: A
Rationale: Systematic reviews and meta-analyses (A) provide the highest level of evidence by synthesizing multiple studies, per evidence-based practice hierarchies. Expert opinions (B), qualitative studies (C), and case studies (D) are less reliable due to subjectivity or limited scope.
The nurse manager reviews the results of a staff satisfaction survey. The feedback requests better engagement from the manager and staff involvement in unit-based decisions. Based on this feedback, the nurse manager plans to adjust their management style to
- A. democratic.
- B. transactional.
- C. laissez-faire.
- D. autocratic.
Correct Answer: A
Rationale: A democratic management style (A) involves staff in decision-making, addressing the feedback for better engagement and involvement. Transactional (B), laissez-faire (C), and autocratic (D) styles do not promote collaborative decision-making.