Nokea
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.
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The nurse manager is completing an annual performance evaluation of a staff nurse. Which elements should the nurse manager include when completing the evaluation? Select all that apply.
- A. The nurses’ bar-code medication administration scan rate
- B. The number of times the nurse has been absent or tardy
- C. The nurse achieving a national certification
- D. The nurses’ performance compared to other staff nurses
- E. The number of medication errors the nurse has self-reported.
Correct Answer: A, B, C, E
Rationale: Bar-code scan rate (A), absences/tardiness (B), national certification (C), and self-reported errors (E) are objective metrics for evaluation. Comparing to other nurses (D) is subjective and biased, inappropriate for inclusion.
The nurse has received the following prescriptions for newly admitted clients. Which prescription should the nurse administer first?
- A. Aspirin to a client experiencing an acute myocardial infarction
- B. Lisinopril to a client with essential hypertension
- C. Risperidone to a client with schizophrenia
- D. Levodopa-carbidopa to a client with Parkinson's disease
Correct Answer: A
Rationale: Aspirin for acute myocardial infarction (A) is the priority to reduce thrombus formation and mortality, per ACS guidelines. Lisinopril (B), risperidone (C), and levodopa-carbidopa (D) address chronic conditions and are less urgent.
The charge nurse is planning client care assignments for a registered nurse (RN) and licensed practical/vocational nurse (LPN/VN). Which of the following clients would be most appropriate to assign to the LPN? Select all that apply. A client
- A. receiving oral antibiotics for lower extremity cellulitis.
- B. newly admitted with an exacerbation of myasthenia gravis.
- C. with a chest tube and receiving mechanical ventilation.
- D. requiring a referral to an outpatient support group.
- E. needing to receive intramuscular RhoGAM.
- F. needing scheduled tube feedings and colostomy irrigations.
Correct Answer: A, E, F
Rationale: Oral antibiotics for cellulitis (A), intramuscular RhoGAM (E), and tube feedings/colostomy irrigations (F) are stable tasks within the LPN’s scope. Myasthenia gravis exacerbation (B), chest tube/ventilation (C), and support group referral (D) require RN assessment or coordination due to instability or complexity.
The nurse is caring for assigned clients in the behavioral health unit. The nurse should initially assess the client who
- A. has postpartum depression who appears unkempt and dejected.
- B. recently lost their family in an accident and currently states, 'I want to be with them.'
- C. has anorexia nervosa and demands that she get reweighed.
- D. refused their second dose of prescribed lithium because of a fine hand tremor.
Correct Answer: B
Rationale: The statement 'I want to be with them' (B) indicates suicidal ideation, requiring immediate assessment for safety. Postpartum depression (A), anorexia demands (C), and lithium refusal (D) are concerning but less urgent.
The nurse is planning client care. It would be a priority for the nurse to intervene if the client with
- A. osteomyelitis receiving intravenous (IV) antibiotics has a temperature of 103.4°F (39.7°C).
- B. viral hepatitis has persistent nausea and vomiting.
- C. septic shock has a mean arterial pressure of 56 mm Hg after a saline bolus.
- D. diverticulitis reports pain 7/10 on the Numerical Rating Scale.
Correct Answer: C
Rationale: A mean arterial pressure of 56 mm Hg in septic shock (C) indicates severe hypotension and organ hypoperfusion, requiring immediate intervention. High fever in osteomyelitis (A), nausea in hepatitis (B), and pain in diverticulitis (D) are serious but less immediately life-threatening.