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The nursing supervisor has implemented a new assignment system for nursing staff. In order to reduce resistance to this new system, the nurse manager should
- A. Provide incentives to foster the change
- B. Allow nursing staff to discuss potential concerns
- C. Provide statistical support for the change
- D. Detail the changes in a multimedia presentation
Correct Answer: B
Rationale: Allowing staff to discuss concerns (B) reduces resistance by fostering open communication and involvement, addressing potential barriers. Incentives (A), statistics (C), and presentations (D) are supportive but less effective without staff input.
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The nurse is caring for assigned clients. The nurse should initially follow up on the client who
- A. has a basilar skull fracture and has bruises under their eyes.
- B. had a craniotomy and has a change in the Glasgow coma scale (GCS) from 13 to 11 in the last hour.
- C. has amyotrophic lateral sclerosis (ALS) and is requesting to have resuscitation efforts withheld.
- D. has Guillain-Barré syndrome (GBS) and is reporting lower extremity muscle weakness.
Correct Answer: B
Rationale: A GCS drop from 13 to 11 post-craniotomy (B) indicates neurological deterioration, possibly from hematoma, requiring immediate follow-up. Bruises with skull fracture (A), ALS DNR request (C), and GBS weakness (D) are less urgent, though GBS needs monitoring.
The nurse is reviewing leadership and management concepts with a student nurse. Which of the following statements by the student nurse would require follow-up?
- A. The Laissez-faire leadership style is a passive leadership approach.
- B. A registered nurse (RN) may delegate accountability to a licensed practical/vocational nurse (LPN/VN).
- C. The rights of delegation include task, circumstance, person, direction, supervision.
- D. The nurse practice act defines roles and responsibilities of nursing professionals.
Correct Answer: B
Rationale: The statement that RNs can delegate accountability to LPNs (B) is incorrect, as RNs remain accountable for delegated tasks. Laissez-faire leadership (A), delegation rights (C), and nurse practice acts (D) are accurately described, requiring no follow-up.
The nurse is developing a staff in-service on negligence. A participant demonstrates correct understanding by identifying which elements must be met in a negligence lawsuit? Select all that apply.
- A. Duty owed
- B. Breach of duty owed
- C. Causation
- D. Harm or damages
- E. Beneficence
Correct Answer: A, B, C, D
Rationale: Negligence requires duty owed (A), breach of duty (B), causation (C), and harm or damages (D). Beneficence (E) is an ethical principle, not a legal element of negligence.
The nurse is caring for a client who expresses feeling self-conscious about their hair and states they would like to wash it before undergoing diagnostic tests and procedures. How should the nurse prioritize the client's care?
- A. Offer the client a cap or scarf to cover their hair and suggest washing it after the diagnostic tests are complete.
- B. The nurse should schedule the testing and meal planning first and complete hygiene as time permits.
- C. Perform the dressing changes first, schedule testing, counsel, and complete hygiene last.
- D. Arrange to wash the client's hair first, perform hygiene, and then complete the diagnostic testing and counseling.
Correct Answer: A
Rationale: Offering a cap/scarf and suggesting washing later (A) addresses the client’s emotional needs while prioritizing timely diagnostics, ensuring medical care is not delayed. Scheduling tests first (B), prioritizing dressings (C), or washing hair first (D) either delays care or ignores efficiency.
The nurse is caring for assigned clients. The nurse should initially follow-up on the client who
- A. has a blood glucose of 250 mg/dL (13.875 mmol/L) while being treated with prednisone for pneumonia.
- B. is receiving a continuous infusion of heparin and has a 50% reduction in platelets over the past five days.
- C. has diabetes mellitus (type two) and reports burning and tingling in both feet.
- D. is being treated for acute post-streptococcal glomerulonephritis and has an hourly urinary output of 20 ml/hr.
Correct Answer: B
Rationale: A 50% platelet drop on heparin (B) suggests heparin-induced thrombocytopenia, a life-threatening condition requiring immediate cessation of heparin. Hyperglycemia (A), neuropathy (C), and low urine output (D) are concerning but less acute, as they are expected or manageable with less urgency.