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The nurse manager overhears multiple conversations on a hospital unit. Based on the statement made, the nurse manager should initiate the process for reporting incivility with which person?
- A. Charge nurse to the nurse, "I need to discuss the medication error you made yesterday."
- B. HCP to the nurse, "Tell me again what the client's vital signs were before I collapsed."
- C. Nurse to a coworker, "You forgot to document the client's noon glucometer reading."
- D. HCP to the client, "I can't do anything more for you; you don't follow my advice anyway."
Correct Answer: D
Rationale: The HCP's statement to the client is demeaning and uncivil, warranting a report for incivility.
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The experienced nurse is observing the new nurse providing care to the hospitalized cheat. Which action requires the experienced nurse to intervene to ensure client safety?
- A. Turns on the client's bathroom light and turns out the room lights after settling the client for sleep
- B. Checks the client's room number and name on the name band to verify client identity prior to giving a medication
- C. Stirs thickening powder into the glass of juice and cup of milk before giving these to the client who has dysphagia
- D. Delays the HCP from performing a thoracentesis by calling "a timeout" to verify the client's identity, consent, procedure, and site
Correct Answer: B
Rationale: Room number is not a unique client identifier. The nurse should use two unique identifiers, such as the client's name and medical record number, to verify identity before medication administration.
The orientation nurse educator reviewing the biohazard legend with a class of new employees states that the emblem is affixed to containers whenever:
- A. there is presence of blood and body fluids.
- B. there is the need for droplet precaution.
- C. there is contact isolation.
- D. there is the potential for airborne transmission.
Correct Answer: A
Rationale: When body substances are handled, the potential for transmission is increased; therefore, federal regulations require warning labels to communicate with other employees and/or waste collectors. The biohazard alert is a three-ring symbol overlaying a central concentric ring. Blood, drainage from wounds, feces, and urine are all body fluids that can transfer infection and disease to others.
The nurse realizes that a fire has started in the client's room. Which action should be taken by the nurse first?
- A. Find the nearest fire alarm to activate.
- B. Extinguish the fire with a blanket.
- C. Remove the client from the room.
- D. Telephone the operator to announce a fire.
Correct Answer: C
Rationale: Removing the client from the room is the priority to ensure their safety from the fire, following the RACE protocol (Rescue, Alarm, Contain, Extinguish).
When an infant car seat is properly installed, the infant should face
- A. forward, so child may look out window
- B. backward, so child faces the seat
- C. the side window, to increase urinary stimulation
- D. upward, as child lies on back with seat installed sideways
Correct Answer: B
Rationale: Infants should be positioned reclining and facing the rear until their leg muscles are strong enough to kick away from the backseat (about 10-12 months-old) for the greatest protection.
Acyclovir (Zovirax) is the agent of choice for which of the following infections?
- A. HIV
- B. AIDS
- C. candida
- D. herpes
Correct Answer: D
Rationale: Acyclovir is an antiviral effective in shortening the duration of infection in herpes. It is used in HIV and AIDS to treat opportunistic viral infections but is not a primary AIDS drug. Candida is a fungus responsive to antifungal medication.