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A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?
- A. Pad the client's wrists before applying the restraints.
- B. Evaluate the client's circulation every 8 hours after application.
- C. Secure the restraint ties to the bed's side rails.
- D. Remove the restraints every 4 hours to evaluate the client's status.
Correct Answer: C
Rationale: The correct answer is C: Secure the restraint ties to the bed's side rails. This is important for ensuring the client's safety and preventing harm. Attaching the restraints to the side rails allows for proper immobilization without causing injury or restricting circulation. Padding the client's wrists (choice A) can be uncomfortable and ineffective. Evaluating circulation every 8 hours (choice B) is not frequent enough for monitoring potential issues. Removing restraints every 4 hours (choice D) can increase the risk of injury and should only be done as necessary.
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What is the term for working on a schedule within the unit, involving only those who are working within that unit?
- A. Flexible staffing
- B. Self-staffing
- C. Internal pools
- D. Management scheduling
Correct Answer: B
Rationale: The correct answer is B: Self-staffing. Self-staffing refers to employees within a unit scheduling themselves to work according to the unit's needs. This approach empowers employees to manage their own schedules, ensuring coverage within the unit.
A: Flexible staffing typically involves adjusting staffing levels based on fluctuating demand, not limited to a specific unit.
C: Internal pools usually refer to a group of employees who can be assigned to various units based on need, not limited to a specific unit.
D: Management scheduling involves supervisors or managers creating schedules for employees, not necessarily limited to a specific unit.
In summary, the term for working on a schedule within the unit involving only those who are working within that unit is self-staffing because it allows employees to self-schedule within their own unit's context.
Which of the following best describes decertification?
- A. Encourage union affiliation
- B. Change union affiliation
- C. Reward union affiliation
- D. Empower union affiliation
Correct Answer: B
Rationale: The correct answer is B: Change union affiliation. Decertification refers to the process of employees voting to remove a union as their bargaining representative. This means changing or ending their current union affiliation.
A: Encouraging union affiliation is not related to decertification, as it involves promoting rather than changing union membership.
C: Rewarding union affiliation is not accurate for decertification, as it does not involve rewarding but rather changing the affiliation.
D: Empowering union affiliation is not the correct choice, as decertification does not enhance but rather changes or removes union representation.
The changes brought forth by the state boards of nursing are an example of which type of change agent?
- A. Resistance
- B. Empirical-rational
- C. Normative-reeducative
- D. Power-coercive
Correct Answer: D
Rationale: The correct answer is D: Power-coercive. State boards of nursing have the authority to enforce regulations and standards through legal power, making them a power-coercive change agent. They can mandate compliance and impose consequences for non-compliance, utilizing their regulatory power to drive change.
A: Resistance is incorrect as state boards of nursing do not resist change but rather implement and enforce it.
B: Empirical-rational is incorrect as this approach involves presenting data and information to persuade individuals to change, which may not align with the state boards' regulatory enforcement.
C: Normative-reeducative is incorrect as it focuses on changing beliefs and values through education and social influence, which is not the primary method used by state boards of nursing for implementing change.
A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?
- A. Hemoglobin A1C level is 7.9%.
- B. Last eye exam was 18 months ago.
- C. Glomerular filtration rate is decreased.
- D. Patient has questions about the prescribed diet.
Correct Answer: C
Rationale: The correct answer is C: Glomerular filtration rate is decreased. This finding is most important to discuss because metformin can potentially worsen kidney function, especially in older adults. A decreased GFR could indicate renal impairment, making it necessary to reevaluate the medication regimen.
A: Hemoglobin A1C level is 7.9% - While this indicates poor diabetic control, it is not as urgent as addressing potential renal issues with metformin.
B: Last eye exam was 18 months ago - While regular eye exams are important for diabetic patients, it is not as critical as addressing renal function.
D: Patient has questions about the prescribed diet - While patient education is crucial, it is not as urgent as addressing potential renal complications.
In summary, the priority is to address the decreased GFR to ensure the patient's safety and well-being.
Which of the following is the preferable alternative to firing an employee?
- A. Voluntary resignation
- B. Training
- C. Confrontation
- D. Coaching
Correct Answer: A
Rationale: The correct answer is A: Voluntary resignation. This option allows the employee to leave on their own terms, preserving their dignity and potentially avoiding negative consequences of being fired. Training (B) may not address the root issue leading to termination. Confrontation (C) can create a hostile environment and damage morale. Coaching (D) is more focused on improving performance rather than addressing termination. Opting for voluntary resignation promotes a more amicable separation and can benefit both the employee and the organization.