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When making assignments for residents of a long-term care facility who require assistance with feeding, which client should the charge nurse assign to the practical nurse (PN) rather than the unlicensed assistive personnel (UAP)?
- A. An elderly woman who refuses to eat most meals served.
- B. A disabled client who is learning to use adaptive equipment.
- C. A client who drools but swallows solids after many attempts.
- D. An older, edentulous client who has loose fitting dentures.
Correct Answer: A
Rationale: The client refusing meals requires a PN's assessment to address potential psychological or physiological issues.
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An unlicensed assistive personnel (UAP) who is working on a skilled nursing unit is diagnosed with hepatitis A (HVA). Two weeks later, a nurse complains of headache, nausea, anorexia, arthralgia, and low-grade fever. Which action should the nurse-manager take next?
- A. Observe the nurse for jaundice and icterus sclera.
- B. Review the immunization status of all unit employees.
- C. Refer the nurse to employee health for serological testing.
- D. Post an employee notice of the outbreak of HVA on the unit.
Correct Answer: C
Rationale: Serological testing confirms HVA, enabling prompt diagnosis and treatment.
A 5-year-old boy with mumps is being transferred to the pediatric unit. Which nursing intervention is most important for the nurse to implement?
- A. Place an isolation cart outside of the room to initiate droplet precautions.
- B. Schedule bedside play time with the occupational therapist.
- C. Instruct the child's parents about the need for transmission precautions.
- D. Assign the child to a room close to the nurse's station.
Correct Answer: A
Rationale: Initiating droplet precautions with an isolation cart prevents mumps transmission, a priority for infection control.
A group of nurse managers is asked to engage in a needs assessment for a piece of equipment that will be expensed to the organization's budget. Which question is most important to consider when analyzing the cost-benefit for this piece of equipment?
- A. How many departments can use this equipment?
- B. Can the equipment be updated each year?
- C. Is the cost of equipment reasonable?
- D. Will the equipment require annual repair?
Correct Answer: C
Rationale: Determining if the cost is reasonable directly evaluates the equipment's value against its benefits, critical for budget decisions.
Several family members are visiting a client who had a myocardial infarction 4 days ago. The unlicensed assistive personnel (UAP) informs the nurse that one of the visitors is lying on the client's bed. Which action should the nurse implement?
- A. Discuss why visitors should not lie in the bed with the client.
- B. Notify the charge nurse that the visitor is lying on the client's bed.
- C. Explain that the client has the right to have a visitor lie on the bed.
- D. Instruct the UAP to ask the visitor to get off the client's bed.
Correct Answer: D
Rationale: Instructing the UAP to address the visitor maintains hygiene and safety efficiently.
An older client who had a hernia repair 12 hours ago suddenly becomes agitated, pulls out the intravenous (IV) catheter, and staggers out into the corridor, demanding to be set free. The nurse assists the client back to bed and re-establishes the IV access. Which intervention is most important for the nurse to implement prior to leaving the client's room?
- A. Discuss with the family about placing the client in a skilled care facility.
- B. Determine if the client is manifesting other neurologic changes.
- C. Apply a restraining device to prevent the client from self injury.
- D. Request family members report when the client is left alone.
Correct Answer: B
Rationale: Assessing for neurologic changes identifies potential causes of agitation, such as delirium or hypoxia.