Nokea
The nurse in the emergency department (ED) assembles a team of nurses to care for a client in cardiac arrest. The nurse is assigning various roles to each nurse and is demonstrating which management style?
- A. Authoritative
- B. Bureaucratic
- C. Democratic
- D. Laissez-faire
Correct Answer: C
Rationale: Assigning roles in a cardiac arrest (C) reflects democratic management, involving collaboration and shared responsibility. Authoritative (A) is directive, bureaucratic (B) follows strict protocols, and laissez-faire (D) lacks structure.
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The nursing supervisor has implemented a new assignment system for nursing staff. In order to reduce resistance to this new system, the nurse manager should
- A. Provide incentives to foster the change
- B. Allow nursing staff to discuss potential concerns
- C. Provide statistical support for the change
- D. Detail the changes in a multimedia presentation
Correct Answer: B
Rationale: Allowing staff to discuss concerns (B) reduces resistance by fostering open communication and involvement, addressing potential barriers. Incentives (A), statistics (C), and presentations (D) are supportive but less effective without staff input.
A nurse observes a colleague failing to perform hand hygiene before entering multiple client rooms and administering medications. What is the most appropriate action by the nurse?
- A. Confront the colleague immediately in a client's room to stop the behavior
- B. Document the incident in the nurse's notes while monitoring for further issues
- C. Immediately report the behavior to the nurse manager for follow-up
- D. Assume the colleague is having a busy shift, and address it at a later time
Correct Answer: C
Rationale: Reporting to the nurse manager (C) ensures prompt follow-up on a serious infection control breach that risks client safety. Confronting in a client’s room (A) is unprofessional, documenting without action (B) delays intervention, and assuming busyness (D) ignores the safety violation.
The nurse is caring for assigned clients. The nurse should first assess the client
- A. with a right femur fracture who reports pain rated as 4 on a scale of 0 (no pain) to 10 (severe pain).
- B. with chronic obstructive pulmonary disease (COPD) who is reporting shortness of breath while ambulating in the hallway.
- C. with a history of T6 spinal injury 6 months ago, now reports a severe headache and is diaphoretic.
- D. one day postoperative from an open cholecystectomy with green drainage from the t-tube.
Correct Answer: C
Rationale: Severe headache and diaphoresis in a T6 spinal injury (C) suggest autonomic dysreflexia, a life-threatening emergency. COPD shortness of breath (B), femur fracture pain (A), and t-tube drainage (D) are less urgent.
The nurse is caring for a client with congestive heart failure. Using the ISBAR format, Select the text that expresses the nurses' recommendation to the physician.
- A. Client reported a cough and shortness of breath while resting.
- B. The onset of symptoms was sudden and not relieved, with the client being positioned with the head of the bed at 90 degrees.
- C. Vital signs were obtained: 156/98; P 108; RR 26/minute; Oxygen saturation 91% on room air.
- D. Lung sounds had crackles in all fields.
- E. A rapid response was called because of the unstable vital signs.
- F. Dr. Thomas Smith was notified to obtain diuretics and critical care monitoring orders.
Correct Answer: B,F
Rationale: Notifying Dr. Smith for diuretics and critical care monitoring (F) is the recommendation in the ISBAR format, proposing specific actions for the physician to address the client’s worsening heart failure. Other options provide situation (A, B), background (C, D), or assessment (E) details.
The nurse is triaging phone calls at the mental health clinic. Which client situation requires immediate follow-up? A client prescribed
- A. olanzapine reporting muscle stiffness and feeling hot.
- B. haloperidol reporting blurred vision and constipation.
- C. clozapine reporting occasional twitches of the mouth.
- D. aripiprazole reporting feeling very restless.
Correct Answer: A
Rationale: Muscle stiffness and feeling hot with olanzapine (A) suggest neuroleptic malignant syndrome, a life-threatening emergency requiring immediate follow-up. Blurred vision/constipation (B), mouth twitches (C), and restlessness (D) are less urgent side effects.