Nokea
The nurse is participating in a committee with the objective of promoting healthcare justice in the community. Which of the following recommendations should the nurse make to achieve the goal?
- A. establishing interdisciplinary collaboration between nursing and nutritional services
- B. providing more confidential waste containers at local drug stores
- C. offering free telehealth offerings in underserved areas of the community
- D. offering inpatient clients the ability to select their meal times
Correct Answer: C
Rationale: Free telehealth in underserved areas (C) promotes healthcare justice by improving access for disadvantaged populations. Interdisciplinary collaboration (A), waste containers (B), and meal time selection (D) are beneficial but less directly address equitable access.
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The nurse has completed medication administration to assigned clients. The nurse should initially follow up on the client who received prescribed
- A. mirtazapine and reports sleepiness.
- B. citalopram and reports nausea.
- C. fluphenazine and reports fever.
- D. clonidine and reports dizziness while rolling over in bed.
Correct Answer: C
Rationale: Fever after fluphenazine (C) suggests neuroleptic malignant syndrome, a life-threatening emergency requiring immediate follow-up. Sleepiness with mirtazapine (A), nausea with citalopram (B), and dizziness with clonidine (D) are expected side effects and less urgent.
The nurse has attended a staff education program about sources of negligent lawsuits. It would indicate effective understanding if the nurse identifies which of the following is a source of a negligent lawsuit?
- A. The nurse documents care under another nurse's username and password
- B. The nurse takes pictures of a client's medical record and distributes them online
- C. The nurse does not notify the physician of a client's critical laboratory result
- D. The nurse treats their spouse in the acute care facility with prescribed medications
Correct Answer: A, B, C, D
Rationale: All options (A, B, C, D) are sources of negligent lawsuits: documenting under another’s credentials (A) is fraudulent, sharing medical records online (B) violates HIPAA, failing to report critical results (C) delays care, and treating a spouse with medications (D) breaches professional boundaries and scope of practice. Since the question implies multiple selections, all are correct.
The nurse is caring for the following assigned clients. It would be a priority to follow up with a client who
- A. has atrial fibrillation and a heart rate of 112/minute.
- B. has glomerulonephritis with a blood pressure of 137/86 mm Hg.
- C. is receiving amphotericin B, and the most recent temperature is 100.4°F (38°C).
- D. has chronic obstructive pulmonary disease (COPD) with an oxygen saturation of 91% on room air.
Correct Answer: A
Rationale: Atrial fibrillation with a heart rate of 112/minute (A) indicates a rapid ventricular response, risking hemodynamic instability or stroke, requiring immediate rate control. Glomerulonephritis with normal BP (B), mild fever with amphotericin (C), and COPD with 91% saturation (D) are less urgent, as they are stable or expected.
During a busy shift, the nurse appropriately delegates tasks to the unlicensed assistive personnel (UAP). Which of the following is the nurse's primary responsibility?
- A. Document the completion of the task.
- B. Make a list of tasks not yet completed to pass on to the next shift.
- C. Observe the UAP for the duration of the task.
- D. Follow-up with the UAP to ensure completion of the task and evaluate the outcome.
Correct Answer: D
Rationale: The nurse’s primary responsibility is to follow up with the UAP (D) to ensure tasks are completed correctly and evaluate outcomes, maintaining accountability for delegated care. Documentation (A), listing incomplete tasks (B), and continuous observation (C) are not primary responsibilities.
The nurse is caring for a group of clients in the labor and delivery department. The nurse should prioritize assessing the client who
- A. is 39 weeks gestation with regular contractions every 3 minutes and reports perineal pressure.
- B. had an epidural placed 3 hours ago and reports a mild headache and has a distended bladder.
- C. delivered a term newborn 4 hours ago and has saturated one peri-pad since delivery and has a temperature of 99.6°F (37.6°C).
- D. is 37 weeks gestation with blood pressure 168/112 mmHg, reports a persistent headache.
Correct Answer: D
Rationale: Severe hypertension (168/112 mmHg) with headache at 37 weeks (D) suggests preeclampsia, a life-threatening emergency requiring immediate assessment to prevent seizures or organ damage. Perineal pressure (A), epidural headache (B), and postpartum findings (C) are less urgent.