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The nurse manager reviews the results of a staff satisfaction survey. The feedback requests better engagement from the manager and staff involvement in unit-based decisions. Based on this feedback, the nurse manager plans to adjust their management style to
- A. democratic.
- B. transactional.
- C. laissez-faire.
- D. autocratic.
Correct Answer: A
Rationale: A democratic management style (A) involves staff in decision-making, addressing the feedback for better engagement and involvement. Transactional (B), laissez-faire (C), and autocratic (D) styles do not promote collaborative decision-making.
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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 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.
The nurse has received a change-of-shift report for assigned clients. The nurse should initially followup on the client with
- A. cystic fibrosis who is coughing up a large amount of yellow mucus.
- B. cellulitis in the lower extremity reporting pain rated 6/10 on the Numerical Rating Scale.
- C. chronic obstructive pulmonary disease reporting blood-tinged sputum 4 hours after a bronchoscopy.
- D. dumping syndrome reporting blurred vision and disorientation.
Correct Answer: A
Rationale: Yellow mucus in cystic fibrosis (A) suggests a possible infection or exacerbation, requiring immediate assessment to prevent respiratory compromise. Cellulitis pain (B), post-bronchoscopy sputum (C), and dumping syndrome symptoms (D) are less urgent, though blurred vision in (D) warrants monitoring.
The nurse is caring for assigned clients. The nurse should initially
- A. administer prescribed antibiotics to a client with bacterial meningitis.
- B. reposition a client with chronic back pain who reports pain rated 6/10 on the Numerical Rating Scale.
- C. remove a nitroglycerin prosthetic transdermal patch for a client with chronic angina.
- D. assess a client who had a coronary artery bypass grafting (CABG) three days ago and has a serum glucose of 135 mg/dL (7.5 mmol/L) [70-110 mg/dL, 3.9-6.1 mmol/L].
Correct Answer: A
Rationale: Antibiotics for bacterial meningitis (A) are critical to prevent rapid deterioration. Repositioning for pain (B), removing nitroglycerin patch (C), and assessing glucose of 135 (D) 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.