Nokea
To help prevent by a dissatisfied client, which objective is most important to include in the orientation classes for staff nurses? New nursing staff members will
- A. demonstrate how to complete an adverse occurrence or variance report.
- B. discuss how to handle complaints from clients and/or their families.
- C. describe how to obtain legal services if needed.
- D. maintain personal malpractice insurance.
Correct Answer: B
Rationale: Teaching nurses to handle complaints effectively can prevent escalation to litigation by resolving conflicts early. Completing variance reports, obtaining legal services, or maintaining insurance are important but less preventive than addressing complaints directly.
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An adult client is admitted via the Emergency Department with a head injury that will initially require intensive care. Which role is responsible for coordinating the progression of this client's care through rehabilitation and discharge?
- A. Nurse case manager.
- B. Adult nurse practitioner.
- C. Neurology unit supervisor.
- D. Risk management nurse.
Correct Answer: A
Rationale: The nurse case manager coordinates the client's care continuum, collaborating with teams from admission to discharge. Other roles focus on specific care aspects, not overall coordination.
When triaging emergency room clients, which client should the nurse assess first?
- A. A male adolescent who has been vomiting for the past 12 hours and describes himself as very weak.
- B. A female client with severe right lower abdominal pain who is febrile and vomiting.
- C. An elderly client with peripheral vascular disease who is complaining of severe leg pain when ambulating.
- D. A child who has had a cold for two days and now is coughing up green sputum.
Correct Answer: B
Rationale: Severe right lower abdominal pain with fever and vomiting suggests appendicitis, a surgical emergency requiring immediate assessment. Vomiting, leg pain, and green sputum are less urgent conditions.
The nurse manager overhears an older female nurse complaining to a co-worker about the time being used to attend an in-service session for bioterrorism preparedness. How should the nurse manager respond?
- A. Choose to send another nurse who is more receptive because the older nurse is not interested.
- B. Ask the nurse why she thinks there is no need for an in-service program about these emergencies.
- C. Inform the older nurse that in-service is not optional and her scheduled attendance is mandatory.
- D. Encourage the nurse to share her concerns and discuss ways to prepare for such emergencies.
Correct Answer: D
Rationale: Encouraging the nurse to share concerns fosters collaboration and addresses barriers to participation, enhancing engagement. Sending another nurse, questioning her views confrontationally, or mandating attendance may create resentment or fail to address her concerns effectively.
The nurse determines that an IV vesicant chemotherapy infusion is infiltrated. In responding to this finding, which task can the nurse delegate to the unlicensed assistive personnel (UAP)?
- A. Record the patient's pulse volume distal to the IV site every hour.
- B. Reapply cold compresses to the site of the extravasation every hour.
- C. Dispose of the IV tubing after the infusion is discontinued.
- D. Teach the patient about the need to keep the extremity elevated.
Correct Answer: C
Rationale: Disposing of IV tubing is a routine task within the UAP's scope. Recording pulse volume, reapplying compresses, and teaching require clinical judgment, which are RN responsibilities.
It is most important to assign which client to a registered nurse rather than a practical nurse (PN)?
- A. One hour after receiving hydromorphone prescribed for every 4 hours PRN use, a client reports severe pain.
- B. Two hours after receiving morphine for acute pain, a client's vital signs are BP 112/60 mm Hg, pulse 88 beats/minute, and respirations 14 breaths/minute.
- C. After ambulating, a postoperative client grimaces and reports incisional pain at a '9 on a ten-point scale'.
- D. The fentanyl transdermal patch for a client with chronic cancer pain needs to be replaced.
Correct Answer: C
Rationale: The postoperative client with severe pain requires immediate RN assessment and intervention due to potential complications. The other clients' needs (PRN medication, stable vitals, routine patch replacement) can be managed by a PN under supervision.