Nokea
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.
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The nurse has become aware of the following client situations. The nurse should first follow up with the client who
- A. has an irregular pulse and is receiving treatment for atrial fibrillation.
- B. has influenza and had an increase in temperature to 102°F (39°C).
- C. is receiving nebulizer treatments for asthma that suddenly stops wheezing.
- D. has an indwelling urinary catheter and reports burning at the insertion site.
Correct Answer: C
Rationale: Sudden cessation of wheezing in asthma (C) may indicate severe airway obstruction, a life-threatening emergency. Irregular pulse (A), fever with influenza (B), and catheter burning (D) are concerning but less immediately critical.
The nurse overhears another nurse state to a client 'If you do not behave, I will restrain you.' This statement demonstrates an example
- A. battery.
- B. libel.
- C. slander.
- D. assault.
Correct Answer: D
Rationale: Threatening restraint for behavior (D) is assault, a verbal threat of harm without physical contact, per legal definitions in healthcare. Battery (A) requires physical contact, libel (B) is written defamation, and slander (C) is spoken defamation, none of which apply.
The nurse has received the following information about assigned clients. The nurse should first assess the client with
- A. pancreatitis who has developed bruising around the umbilicus.
- B. a capillary blood glucose of 159 mg/dL (8.83 mmol/L) [70-110 mg/dL; 4-6 mmol/L] while receiving total parenteral nutrition.
- C. a blood pressure of 156/92 mmHg who sustained an ischemic stroke six hours ago.
- D. stable angina reporting headache while receiving nitroglycerin via transdermal patch.
Correct Answer: A
Rationale: Umbilical bruising in pancreatitis (A) suggests Cullen’s sign, indicating possible retroperitoneal hemorrhage, a life-threatening emergency. Mild hyperglycemia (B), elevated BP post-stroke (C), and nitroglycerin headache (D) are less urgent, as they are expected or manageable.
The nurse cares for an infant undergoing a surgical repair of a total anomalous pulmonary venous return tomorrow. The doctor has talked to the parents and obtained consent. The mother tells the nurse, 'I'm not so sure about this. What if my baby dies?' The nurse's most appropriate response is:
- A. Explain the procedure to the mother.
- B. Notify the surgical team and have them come back to speak with the mother again.
- C. Reassure the mother that everything will go as planned.
- D. Tell the mother that because she has already signed the consent, she cannot change her mind now.
Correct Answer: B
Rationale: Notifying the surgical team (B) ensures the mother’s concerns are addressed by the provider, respecting her need for clarification. Explaining the procedure (A) is the physician’s role, false reassurance (C) is inappropriate, and stating consent is irrevocable (D) is incorrect and dismissive.
The nurse observes another nurse starting their shift under the influence of alcohol and decides not to report the nurse to the supervisor. Which ethical principle is the nurse violating?
- A. Confidentiality
- B. Nonmaleficence
- C. Justice
- D. Beneficence
Correct Answer: B
Rationale: Not reporting a nurse under the influence violates nonmaleficence (B), as it risks harm to clients due to impaired care. Confidentiality (A) is unrelated, justice (C) pertains to fairness, and beneficence (D) involves promoting good, which is secondary to preventing harm.