Nokea
The nurse triages phone calls for the primary healthcare provider (PHCP). Which client report requires immediate follow-up? A client reporting
- A. bilateral flank pain who has two nephrostomy tubes.
- B. abdominal cramping while instilling dialysate for peritoneal dialysis (PD).
- C. facial edema while being treated for nephrotic syndrome.
- D. a localized rash following the administration of ciprofloxacin for cystitis.
Correct Answer: C
Rationale: Facial edema in nephrotic syndrome (C) suggests worsening hypoalbuminemia or fluid overload, a medical emergency requiring immediate follow-up. Flank pain (A), dialysis cramping (B), and rash (D) are less urgent, as they are expected or manageable.
You may also like to solve these questions
The nurse has received the following prescriptions for newly admitted clients. Which prescription should the nurse administer first?
- A. Aspirin to a client experiencing an acute myocardial infarction
- B. Lisinopril to a client with essential hypertension
- C. Risperidone to a client with schizophrenia
- D. Levodopa-carbidopa to a client with Parkinson's disease
Correct Answer: A
Rationale: Aspirin for acute myocardial infarction (A) is the priority to reduce thrombus formation and mortality, per ACS guidelines. Lisinopril (B), risperidone (C), and levodopa-carbidopa (D) address chronic conditions and are less urgent.
The nurse manager is completing an annual performance evaluation of a staff nurse. Which elements should the nurse manager include when completing the evaluation? Select all that apply.
- A. The nurses’ bar-code medication administration scan rate
- B. The number of times the nurse has been absent or tardy
- C. The nurse achieving a national certification
- D. The nurses’ performance compared to other staff nurses
- E. The number of medication errors the nurse has self-reported.
Correct Answer: A, B, C, E
Rationale: Bar-code scan rate (A), absences/tardiness (B), national certification (C), and self-reported errors (E) are objective metrics for evaluation. Comparing to other nurses (D) is subjective and biased, inappropriate for inclusion.
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.
The nurse is assisting the risk manager in reviewing a serious medication error. Which process should the nurse recommend be used to identify the origin of the issue and potential solution?
- A. Root cause analysis
- B. Collective bargaining
- C. Six Sigma
- D. Team STEPPS program
Correct Answer: A
Rationale: Root cause analysis (A) is the standard process to identify the origin of a medication error and develop solutions by analyzing contributing factors. Collective bargaining (B) is labor-related, Six Sigma (C) is a quality methodology, and Team STEPPS (D) focuses on teamwork, none specific to error investigation.
The nurse is caring for a client who was involuntarily admitted to the behavioral health unit. The client has received a package in the mail. What action should the nurse take?
- A. Provide the client with the package
- B. Open the package to review its content
- C. Provide the package upon discharge
- D. Determine if the sender is the client's next of kin
Correct Answer: B
Rationale: Opening the package to review its content (B) ensures safety by checking for harmful items, a standard practice in behavioral health units. Giving the package immediately (A), at discharge (C), or checking the sender (D) is inappropriate without inspection.