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The nurse preceptor educates the new graduate nurse that which of the following statements made by an elderly client indicate the achievement of ego integrity? Select all that apply.
- A. I wish I could change some things in my past.'
- B. I’d like to volunteer at the youth center a few days a week.'
- C. I’m thinking of helping people learn to read and write.'
- D. I signed up for an art class at the senior center.'
- E. I never achieved the career title I should have'
Correct Answer: B, C, D
Rationale: Volunteering (B), teaching literacy (C), and joining an art class (D) reflect ego integrity, showing life acceptance and purpose per Erikson’s theory. Regret over past (A) or career (E) indicates despair, not integrity.
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The emergency department (ED) nurse is triaging clients in the ED. It would be appropriate for the nurse to triage which client as nonurgent? Select all that apply.
- A. with a localized abscess on the right leg.
- B. reporting that they have chest pressure.
- C. with nausea, vomiting, and painful urination.
- D. requesting a refill of their prescribed antidepressant.
- E. with a single laceration to the left hand.
Correct Answer: A, D, E
Rationale: Nonurgent conditions include a localized abscess (A), antidepressant refill (D), and a single laceration (E), as they are stable and do not require immediate intervention. Chest pressure (B) suggests a cardiac emergency, and nausea, vomiting, and painful urination (C) indicate a possible urinary tract infection, both requiring urgent attention.
The nurse is caring for assigned clients. Which of the following clients would be appropriate for the nurse to refer for an interdisciplinary conference? A client with Select all that apply.
- A. pulmonary tuberculosis with multiple prescriptions.
- B. ischemic stroke who has left-sided hemiplegia.
- C. hyperthyroidism and is scheduled for a thyroidectomy.
- D. stage one Alzheimer’s disease who lives with family.
- E. fractured tibia and fibula and is homeless.
- F. end-stage-renal disease who refuses dialysis.
Correct Answer: A, B, E, F
Rationale: TB with multiple drugs (A), stroke with hemiplegia (B), homeless with fractures (E), and dialysis refusal (F) require interdisciplinary coordination due to complex medical, social, or ethical needs. Thyroidectomy (C) and early Alzheimer’s (D) are less complex for conferencing.
The nurse manager has observed a staff nurse return to work late multiple times following the lunch break. The nurse manager should take which initial action?
- A. Continue to observe the nurse's behavior
- B. Reprimand the nurse with written documentation
- C. Ask the nurse to check in before and after taking their lunch break
- D. Discuss with the nurse the consequences of being late
Correct Answer: C
Rationale: Asking the nurse to check in (C) is a proactive initial step to address tardiness while maintaining professionalism and gathering data. Continued observation (A) delays action, reprimand (B) is premature, and discussing consequences (D) escalates without initial intervention.
The nursing supervisor is preparing to complete performance appraisals on subordinate staff members. In order to minimize bias when conducting the evaluations, the nurse supervisor should
- A. compare the performance of the nurse with another nurse.
- B. focus on a positive experience and rate all areas based on that measure.
- C. review the employee’s previous evaluations before completing the new evaluation.
- D. gather feedback from peers regarding skills, performance, attitude, and competencies.
Correct Answer: D
Rationale: Gathering peer feedback (D) minimizes bias by providing a broader, objective perspective on performance. Comparing nurses (A) or focusing on one experience (B) introduces bias, and relying only on past evaluations (C) may miss current performance.
A registered nurse (RN) and a licensed practical/vocational nurse (LPN/VN) are working together in a psychiatric ward. Which of the following clients can the RN assign to the LPN/VN? A client
- A. taking amitriptyline who is currently grinding their jaw and grimacing
- B. with dementia who is currently confused and disoriented
- C. with bipolar disorder with a lithium level of 2.0 mEq/L [0.6-1.2 mEq/L]
- D. with a history of chronic alcoholism currently experiencing delirium tremens
Correct Answer: B
Rationale: A client with dementia who is confused (B) is stable and suitable for LPN care, focusing on safety and routine tasks. Jaw grinding on amitriptyline (A), toxic lithium level (C), and delirium tremens (D) require RN assessment due to potential toxicity or instability.