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The nurse is planning a staff development conference about changing the process of how clients are seen at a clinic to a first come, first served basis. This proposed change will model which ethical principle?
- A. Nonmaleficence
- B. Veracity
- C. Paternalism
- D. Justice
Correct Answer: D
Rationale: A first-come, first-served process (D) models justice by ensuring fair and equitable access to care based on arrival time. Nonmaleficence (A), veracity (B), and paternalism (C) do not apply to this resource allocation change.
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The nursing supervisor is preparing to complete performance appraisals on subordinate staff members. In order to minimize bias when conducting the evaluations, the nurse supervisor should
- A. compare the performance of the nurse with another nurse.
- B. focus on a positive experience and rate all areas based on that measure.
- C. review the employee’s previous evaluations before completing the new evaluation.
- D. gather feedback from peers regarding skills, performance, attitude, and competencies.
Correct Answer: D
Rationale: Gathering peer feedback (D) minimizes bias by providing a broader, objective perspective on performance. Comparing nurses (A) or focusing on one experience (B) introduces bias, and relying only on past evaluations (C) may miss current performance.
The nurse is caring for a client recovering from hip surgery who needs to regain strength to climb the flight of stairs leading to their bedroom at home. The nurse should recommend a referral to a
- A. physical therapist (PT).
- B. nutritionist.
- C. C. case manager.
- D. D. occupational therapist (OT).
Correct Answer: A
Rationale: A physical therapist (A) specializes in improving strength and mobility, essential for stair climbing post-hip surgery. Nutritionists (B) focus on diet, case managers (C) coordinate care, and occupational therapists (D) address daily living activities.
The nurse cares for a client immediately following a percutaneous coronary intervention (PCI). Upon sheath removal, the client develops bradycardia and hypotension. Which intervention would be the nurse’s priority?
- A. Assess bilateral pedal pulses
- B. Apply a sandbag to stabilize the site
- C. Administer prescribed bolus of intravenous (IV) fluids
- D. Elevate the head of the bed
Correct Answer: C
Rationale: Bradycardia and hypotension post-PCI sheath removal (D) suggest a vasovagal response or bleeding, requiring a fluid bolus (C) to stabilize circulation, per ACLS guidelines. Pulse assessment (A), sandbag application (B), and head elevation (D) are secondary or inappropriate.
A registered nurse (RN) and a licensed practical/vocational nurse (LPN/VN) are working together in a psychiatric ward. Which of the following clients can the RN assign to the LPN/VN? A client
- A. taking amitriptyline who is currently grinding their jaw and grimacing
- B. with dementia who is currently confused and disoriented
- C. with bipolar disorder with a lithium level of 2.0 mEq/L [0.6-1.2 mEq/L]
- D. with a history of chronic alcoholism currently experiencing delirium tremens
Correct Answer: B
Rationale: A client with dementia who is confused (B) is stable and suitable for LPN care, focusing on safety and routine tasks. Jaw grinding on amitriptyline (A), toxic lithium level (C), and delirium tremens (D) require RN assessment due to potential toxicity or instability.
The nurse is triaging a group of pediatric clients. The nurse should first see the client who is
- A. reporting pain 5/10 on the Numerical Rating Scale after burning their right forearm.
- B. drooling and experiencing difficulty with swallowing.
- C. experiencing a temperature of 101.1°F (38.4°C) and a headache.
- D. reporting excessive thirst and has a thready peripheral pulse.
Correct Answer: B
Rationale: Drooling and difficulty swallowing (B) suggest airway obstruction, such as epiglottitis, a life-threatening emergency. Burns (A), fever with headache (C), and thirst with thready pulse (D) are concerning but less immediately critical.