Nokea
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.
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You are caring for a group of psychiatric mental health clients. One of these clients, who has anger management and aggressive behavior concerns, has not yet gained telephone privileges. You notice an unlicensed assistive personnel (UAP) on the unit escorting this client to the telephone. After you speak to the client about the telephone privileges, the UAP tells you, 'It is unfair for this client not to be able to use the telephone when other clients are free to do so.' What should you determine about this UAP’s comment?
- A. This comment demonstrates that the unlicensed assistive personnel (UAP) favors this client.
- B. This comment indicates that the unlicensed assistive personnel (UAP) is ensuring equal rights.
- C. This comment indicates that the unlicensed assistive personnel (UAP) is preventing discrimination.
- D. This comment indicates a learning need for the unlicensed assistive personnel (UAP) relating to the therapeutic milieu.
Correct Answer: D
Rationale: The UAP’s comment (D) reflects a lack of understanding of the therapeutic milieu, where restrictions like telephone privileges are part of a care plan to manage aggression. It does not indicate favoritism (A), equal rights (B), or anti-discrimination (C), but a need for education on unit protocols.
The nurse in the emergency department (ED) is triaging clients. The nurse should immediately follow up on the client who
- A. is being treated for depression and is requesting a refill of the prescribed antidepressant.
- B. is receiving external-beam radiation for breast cancer and reports blistering at the site.
- C. fell while riding their bicycle and has bruising and abrasions to the right upper extremities.
- D. reports left testicular pain and swelling with nausea and vomiting.
Correct Answer: D
Rationale: Testicular pain/swelling with nausea (D) suggests testicular torsion, an emergency requiring immediate follow-up to prevent organ loss. Depression refill (A), radiation blisters (B), and abrasions (C) are less urgent.
The nurse is caring for a client who reports that another nurse hit them. The nurse should take which action?
- A. Inquire with the nurse if this incident occurred
- B. Assess the client for any prior episodes of abuse
- C. Determine if the client has any cognitive impairments
- D. Report the client's concern to the nursing supervisor
Correct Answer: D
Rationale: Reporting the allegation to the nursing supervisor (D) is the priority to ensure proper investigation and client safety, per facility policy. Inquiring directly (A), assessing prior abuse (B), or checking cognition (C) risks bias or delays formal action.
The nurse is developing a care plan for a client with Bell's palsy. Which problem should the nurse prioritize in the care plan?
- A. Risk for infection
- B. Risk for disturbed sensory perception
- C. Risk for disturbed body image
- D. Risk for ineffective tissue perfusion
Correct Answer: B
Rationale: Risk for disturbed sensory perception (B) is the priority in Bell’s palsy due to facial paralysis, which can lead to corneal abrasion or oral injury. Infection (A), body image (C), and perfusion (D) are secondary concerns.
During a bath, the unlicensed assistive personnel (UAP) reports to the nurse that the client has malodorous discharge from the gastrostomy tube. The nurse should initially
- A. obtain a specimen for culture.
- B. assess the drainage.
- C. place a sterile dressing around the gastrostomy tube.
- D. assess the client's temperature for fever.
Correct Answer: B
Rationale: Assessing the drainage (B) is the first step to determine the cause, such as infection or tube malfunction, guiding further action. Obtaining a culture (A), applying a dressing (C), or checking for fever (D) are secondary without initial assessment data.