Nokea
How can a nurse manager best improve hand-off communication among the staff? (SATA)
- A. Attending hand-off rounds to coach and mentor.
- B. Conducting audits of staff using a new template.
- C. Creating a template of topics to include in the report.
- D. Utilizing the SHARE model as a tool for standardizing hand-off reports and other critical communication.
Correct Answer: D
Rationale: The correct answer is D because utilizing the SHARE model helps standardize hand-off reports and communication.
1. S stands for Situation: providing context.
2. H stands for History: outlining relevant information.
3. A stands for Assessment: sharing assessment findings.
4. R stands for Recommendation: suggesting actions.
5. E stands for Explanation: clarifying any questions.
This model ensures all necessary information is communicated effectively. A, B, and C are incorrect because attending hand-off rounds, conducting audits, and creating templates may not ensure standardized communication like the SHARE model does.
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A client with hypertension is being taught about lifestyle modifications. Which statement by the client indicates a need for further teaching?
- A. I will reduce my sodium intake to help control my blood pressure.
- B. I need to start walking at least 30 minutes most days of the week.
- C. I can continue drinking alcohol as long as it is not in excess.
- D. I will check my blood pressure regularly at home.
Correct Answer: C
Rationale: The correct answer is C because excessive alcohol consumption can raise blood pressure. Step 1: Alcohol can lead to hypertension. Step 2: Limiting alcohol intake is crucial in managing hypertension. Step 3: Choices A, B, and D promote healthy behaviors that help control blood pressure. Summary: Choice C is incorrect as it goes against hypertension management, while choices A, B, and D align with lifestyle modifications for hypertension.
In conducting a primary survey on a trauma patient, which of the following is considered one of the priority elements of the primary survey?
- A. Complete set of vital signs
- B. Palpation and auscultation of the abdomen
- C. Brief neurologic assessment
- D. Initiation of pulse oximetry
Correct Answer: C
Rationale: A brief neurologic assessment helps quickly identify potential brain injuries or other neurological deficits.
What is the rationale for using preoperative checklists on the day of surgery?
- A. The patient is correctly identified.
- B. All preoperative orders and procedures have been carried out and records are complete.
- C. Patients' families have been informed as to where they can accompany and wait for patients.
- D. Preoperative medications are the last procedure before the patient is transported to the operating room.
Correct Answer: B
Rationale: Checklists ensure all necessary steps are completed, enhancing patient safety.
A client with chronic obstructive pulmonary disease (COPD) who has been receiving oxygen therapy at 2 L/min now has a respiratory rate of 10 breaths/min. What action should the nurse take first?
- A. Increase the oxygen flow rate to 4 L/min.
- B. Administer a bronchodilator via nebulizer.
- C. Encourage the client to take deep breaths.
- D. Assess the client's mental status and level of consciousness.
Correct Answer: D
Rationale: The correct answer is D, assessing the client's mental status and level of consciousness. This is the first action to take because a respiratory rate of 10 breaths/min in a COPD client receiving oxygen therapy may indicate respiratory depression or impending respiratory failure. Assessing mental status and level of consciousness can help determine if the client is experiencing hypoxia. Increasing oxygen flow rate (A) without assessing the client first can be dangerous if the client is retaining carbon dioxide. Administering a bronchodilator (B) may not address the underlying issue of respiratory depression. Encouraging deep breaths (C) may not be appropriate if the client is in respiratory distress.
What should the nurse instruct Mr. Ross to withhold food and fluid for several hours until after fiberoptic bronchoscopy?
- A. Sputum returns to normal color and consistency
- B. Speech returns to the normal pattern
- C. Vital signs become stable
- D. Cough reflex is present
Correct Answer: D
Rationale: A functioning cough reflex prevents aspiration.