Nokea
The nurse-manager overhears an older female nurse complaining to a co-worker about the time being used to attend an in-service session for bioterrorism preparedness. How should the nurse-manager respond?
- A. Ask the nurse why she thinks there is no need for an in-service program about these emergencies.
- B. Encourage the nurse to share her concerns and discuss ways to prepare for such emergencies.
- C. Choose to send another nurse who is more receptive because the older nurse is not interested.
- D. Inform the older nurse that in-service is not optional and her scheduled attendance is mandatory.
Correct Answer: B
Rationale: Encouraging discussion fosters collaboration and addresses concerns constructively.
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An older adult woman with end stage heart disease is alert and oriented and states that she does not want any heroic measures taken in the event she stops breathing. The client's children tell the nurse that they accept their mother's wishes and do not want to watch her suffer. Which action should the nurse take first?
- A. Consult the palliative care team.
- B. Obtain a do not resuscitate prescription.
- C. Define the term heroic measures.
- D. Coordinate a family conference.
Correct Answer: B
Rationale: Obtaining a DNR prescription legally documents the client's wishes, a priority action.
Four clients are scheduled to receive IV infusions, but there are only three intravenous (IV) pumps available. Which prescribed infusion can most safely be administered without an IV infusion pump?
- A. Heparin in Normal Saline prescribed for deep vein thrombosis.
- B. Regular Insulin in Normal Saline prescribed for ketoacidosis.
- C. Magnesium in Normal Saline prescribed for hypomagnesemia.
- D. Ceftriaxone in 5% Dextrose in Water prescribed for pneumonia.
Correct Answer: D
Rationale: Ceftriaxone can be safely administered via gravity drip over 30 minutes, unlike high-alert medications like heparin, insulin, or magnesium.
The nurse-manager observes that the staff nurse has used wrist restraints to help secure an elderly female in her wheelchair. The client is pleading for the nurse to release her arms. The nurse explains to the nurse-manager that the client needs to be restrained in the wheelchair so that the nurse can change her bed linens. Which is the priority action by the nurse-manager?
- A. Contact the healthcare provider to ensure that a prescription for restraints was written.
- B. Advise the staff nurse to remove the restraints from the client's wrists.
- C. Determine if the client has an as needed (PRN) prescription for an antianxiety agent.
- D. Close the door to the room to avoid disturbing other clients in nearby rooms.
Correct Answer: B
Rationale: Removing restraints prioritizes the client's autonomy and safety, avoiding harm from inappropriate use.
A charge nurse agrees to cover another nurse's assignment during a lunch break. Based on the status report provided by the nurse who is leaving for lunch, which client should be checked first by the charge nurse?
- A. The client post triple coronary bypass four days ago who has serosanguinous drainage in one chest tube.
- B. The client admitted yesterday with diabetic ketoacidosis whose blood glucose level is now 195 mg/dL (10.8 mmol/L).
- C. The client with an ileal conduit created two days ago with a scant amount of blood in the drainage pouch.
- D. The client with a pneumothorax secondary to a gunshot wound with a current pulse oximeter reading of 90%.
Correct Answer: D
Rationale: The pneumothorax client with low oxygen saturation is at risk of respiratory failure, requiring immediate assessment.
A male client who fell at home and experienced a brief loss of consciousness becomes increasingly confused after admission to the medical unit. The family provides the client's signed power of attorney and a home medication list. When reporting to the healthcare provider using SBAR (Situation, Background, Assessment, Recommendation) communication, which information should the nurse provide first?
- A. Client's healthcare power of attorney.
- B. Increasing confusion of the client.
- C. Currently prescribed medications.
- D. Fall at home as reason for admission.
Correct Answer: B
Rationale: Increasing confusion is the urgent situation, indicating potential neurological deterioration.