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Two unlicensed assistive personnel (UAP) are arguing on the unit about who deserves to take a break first. What is the most important basic guideline that the nurse should follow in resolving the conflict?
- A. Require the UAPs to reach a compromise.
- B. Weigh the consequences of each possible solution.
- C. Encourage the two to view the humor of the conflict.
- D. Deal with issues and not personalities.
Correct Answer: D
Rationale: The correct answer is D: Deal with issues and not personalities. This guideline is important because it focuses on resolving the conflict based on the actual problem at hand, rather than personal biases or emotions. By addressing the issues causing the argument, the nurse can help the UAPs find a fair and logical solution.
A: Requiring the UAPs to reach a compromise may not address the root cause of the conflict and could lead to further disagreements.
B: Weighing the consequences is important but may not be as effective in resolving the conflict as directly addressing the issues.
C: Encouraging humor may temporarily diffuse the situation but may not lead to a lasting resolution.
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The nurse is preparing for insertion of a pulmonary artery acbairtbh.ceotme/rte (sPt AC). During insertion of the catheter, what are the priority nursing actions? (Select all that apply.)
- A. Allay the patient’s anxiety by providing information ab out the procedure.
- B. Ensure that a sterile field is maintained during the inse rtion procedure.
- C. Inflate the balloon during the procedure when indicated by the physician.
- D. Monitor the patient’s cardiac rhythm throughout the en tire procedure.
Correct Answer: B
Rationale: The correct answer is B: Ensure that a sterile field is maintained during the insertion procedure. This is the priority nursing action because maintaining a sterile field is crucial to prevent infection during the invasive procedure. The nurse must follow strict aseptic technique to reduce the risk of introducing bacteria into the patient's bloodstream. All other choices are incorrect: A: Addressing the patient's anxiety is important but not the priority during the insertion procedure. C: Inflating the balloon is a specific action that should be performed by the physician, not the nurse. D: While monitoring the patient's cardiac rhythm is important, ensuring the sterile field takes precedence to prevent complications.
The nurse has identified an increase in medication errors in the critical care unit over the past several months. What aspect of medication procedures should be evaluated first?
- A. Adherence to procedures by nursing staff
- B. Clarity of interdisciplinary communication
- C. Number of new employees on the unit
- D. Changes in administration procedures
Correct Answer: A
Rationale: The correct answer is A: Adherence to procedures by nursing staff. This should be evaluated first because medication errors are often caused by human factors such as staff not following proper procedures. By assessing adherence, the root cause of errors can be identified and addressed.
Choice B: Clarity of interdisciplinary communication may contribute to errors but doesn't directly address staff adherence to procedures.
Choice C: Number of new employees could be a factor, but focusing on adherence to procedures is more crucial.
Choice D: Changes in administration procedures may impact errors, but evaluating staff adherence is more immediate and directly related to errors.
The patient is complaining of severe flank pain when he tries to urinate. His urinalysis shows sediment and crystals along with a few bacteria. Using this information along with the clinical picture, the nurse realizes that the patient’s condition is
- A. prerenal.
- B. postrenal.
- C. intrarenal.
- D. not renal related.
Correct Answer: C
Rationale: The correct answer is C: intrarenal. The presence of sediment, crystals, and bacteria in the urinalysis indicates an issue originating within the kidney itself. This suggests a problem like a urinary tract infection or kidney stone causing the severe flank pain. Prerenal and postrenal conditions usually involve issues outside the kidney such as dehydration or urinary tract obstruction, which are not supported by the urinalysis findings. Choice D, not renal related, is incorrect as the symptoms and urinalysis results clearly point towards a renal issue.
The nurse is caring for a patient who is being evaluated clianbiircba.clolmy/ tfeostr brain death by a primary care provider. Which assessment findings by the nurse sup port brain death?
- A. Absence of a corneal reflex
- B. Unequal, reactive pupils
- C. Withdrawal from painful stimuli
- D. Core temperature of 100.8° F
Correct Answer: A
Rationale: The correct answer is A, absence of a corneal reflex, because in brain death, all brainstem reflexes, including the corneal reflex, are absent. This indicates complete loss of brain function. Choice B, unequal reactive pupils, is incorrect as it suggests some level of brainstem function. Choice C, withdrawal from painful stimuli, is also incorrect as it is a spinal reflex and can occur even in the absence of brain function. Choice D, core temperature of 100.8° F, is irrelevant to assessing brain death.
A 65-year-old patient admitted to the progressive care unit with a diagnosis of community-acquired pneumonia, has a history of chronic obstructive pulmonary disease and diabetes. A set of arterial blood gases obtained on admissiaobnir bw.coitmh/oteustt supplemental oxygen shows pH 7.35; PaCO 55 mm Hg; bicarbonate 30 mEq/L ; PaO 65 mm Hg. These blood 2 2 gases reflect what condition?
- A. Hypoxemia and compensated metabolic alkalosis.
- B. Hypoxemia and compensated respiratory acidosis.
- C. Normal oxygenation and partly compensated metaboli c alkalosis.
- D. Normal oxygenation and uncompensated respiratory acidosis.
Correct Answer: B
Rationale: The correct answer is B: Hypoxemia and compensated respiratory acidosis. The patient's pH is within normal range (7.35), indicating compensation. The elevated PaCO2 (55 mm Hg) indicates respiratory acidosis due to inadequate ventilation, likely from COPD. The low PaO2 (65 mm Hg) indicates hypoxemia, common in pneumonia. The normal bicarbonate level (30 mEq/L) suggests metabolic compensation for respiratory acidosis. Choice A is incorrect as there is no metabolic alkalosis present. Choice C is incorrect as the patient has hypoxemia. Choice D is incorrect as the patient is showing compensated respiratory acidosis, not uncompensated.