Nokea
The nurse overhears an unlicensed assistive personnel (UAP) shout at a client, 'you will have to get a feeding tube if you do not start eating more at mealtimes.' The nurse recognizes that the UAP has Select all that apply.
- A. committed battery.
- B. engaged in unprofessional conduct.
- C. committed assault.
- D. been negligent.
- E. demonstrated libel.
Correct Answer: B, C
Rationale: Shouting and threatening a feeding tube (B, C) constitutes unprofessional conduct (B) and assault (C), a verbal threat of harm. Battery (A) requires physical contact, negligence (D) involves failure of duty, and libel (E) is written defamation, none of which apply.
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A 30-year old patient presents to the Emergency Department with alcohol withdrawal seizures. The psychiatry nurse understands that the patient will soon be admitted to the non-medical psychiatric care unit. To keep this patient safe, the nurse must perform which priority nursing action?
- A. Ask the physician for a clonazepam prescription, an anxiolytic that may help with the withdrawal symptoms.
- B. Ensure that a working IV pump is set up at the patient's bedside.
- C. Order a STAT arterial blood gas (ABG).
- D. Pad the side rails of the patient's assigned bed.
Correct Answer: D
Rationale: Padding the side rails (D) is the priority to prevent injury during ongoing or recurrent seizures in alcohol withdrawal, ensuring immediate safety. Requesting clonazepam (A) requires a physician order and is secondary, IV pump setup (B) is not urgent unless medication is ordered, and ABG (C) is unnecessary unless respiratory distress is present.
The client has just been given an IV dose of morphine 6 mg for neuropathic pain. A few minutes later, the nurse notes that the client's respirations are now 8, and his blood pressure has dropped from 122/83 mmHg to 88/67 mmHg. Which nursing action is the most appropriate?
- A. Prepare for intubation.
- B. Prepare to administer a dopamine infusion.
- C. Administer naloxone.
- D. Start an IV infusion of normal saline.
Correct Answer: C
Rationale: Respiratory depression (RR 8) and hypotension post-morphine (C) indicate opioid overdose, requiring naloxone to reverse effects, per ACLS guidelines. Intubation (A), dopamine (B), and saline (D) are secondary or inappropriate without reversal.
The nurse has become aware of the following client situations. The nurse should first follow up with which client? A client
- A. with a chest tube that has tidaling in the water seal chamber.
- B. that is receiving mechanical ventilation and is occasionally biting on the tube.
- C. that is receiving albuterol via a nebulizer and reports headache and nervousness.
- D. with pneumonia that has become restless and confused.
Correct Answer: D
Rationale: Restlessness and confusion in pneumonia (D) suggest hypoxia or worsening infection, requiring immediate follow-up to prevent deterioration. Chest tube tidaling (A) is normal, tube biting (B) is concerning but less acute, and albuterol side effects (C) are expected.
The nurse in charge of the labor and delivery department is making the client assignments for the day. Which client should the most experienced nurse receive?
- A. A 40-week pregnant client attached to the fetal monitor having late decelerations.
- B. A 39-week pregnant client in labor with contractions 3 minutes apart.
- C. A 33-week pregnant client with triplets who is on bed rest.
- D. A 26-week pregnant client who is having Braxton Hicks contractions.
Correct Answer: A
Rationale: Late decelerations at 40 weeks (A) indicate fetal distress, requiring the most experienced nurse for close monitoring and potential intervention. Active labor (B), preterm triplets (C), and Braxton Hicks (D) are less critical or stable, suitable for less experienced staff.
The nurse is preparing medications for the shift. Which of the following clients should the nurse prioritize for immediate medication administration?
- A. Digoxin to a client with atrial fibrillation
- B. Furosemide to a client with congestive heart failure
- C. Magnesium sulfate to a client with Torsades de pointes
- D. Labetalol to a client with a blood pressure of 160/100 mmHg
Correct Answer: C
Rationale: Magnesium sulfate for Torsades de pointes (C) is the priority to stabilize life-threatening ventricular arrhythmias, per ACLS guidelines. Digoxin (A), furosemide (B), and labetalol (D) address less acute conditions.