Nokea
Which of the following would be considered an urgent and important issue?
- A. Replacing two staff who were injured while caring for a violent patient
- B. Updating the employee break room with new furniture
- C. Preparing educational packets on self-administration of insulin for patients
- D. Arranging a team-building event for staff members
Correct Answer: A
Rationale: The correct answer is A because replacing injured staff dealing with a violent patient is urgent due to staff shortage and important for patient safety. Choice B is not urgent or directly related to patient care. Choice C is important but not urgent. Choice D is important for team morale but not urgent or directly related to patient care.
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A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?
- A. BUN 21 mg/dL (10 to 20 mg/dL)
- B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
- C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
- D. Sodium 132 mEq/L (136 to 145 mEq/L)
Correct Answer: B
Rationale: The correct answer is B: Potassium 5.8 mEq/L. In hypovolemia, there is a decrease in blood volume leading to electrolyte imbalances. Potassium levels outside the normal range can be life-threatening, causing cardiac arrhythmias. Therefore, a potassium level of 5.8 mEq/L is a priority to report to the provider for prompt intervention.
Rationale for why the other choices are incorrect:
A: BUN within the normal range. It may indicate dehydration but not immediately life-threatening.
C: Creatinine slightly elevated, indicating kidney function impairment but not as critical as potassium imbalance.
D: Sodium within acceptable range, not an immediate concern in hypovolemia.
During a staffing crisis, managers may need to use nurse extenders. These individuals are better known as:
- A. Float RNs.
- B. Unlicensed assistive personnel.
- C. LPNs.
- D. Agency nurses.
Correct Answer: B
Rationale: The correct answer is B: Unlicensed assistive personnel. Nurse extenders are typically nursing assistants or other unlicensed staff who provide basic patient care under the supervision of registered nurses. They help alleviate the workload during staffing shortages but do not have the same level of education and training as licensed nurses. Float RNs (A) are registered nurses who work in various units as needed. LPNs (C) are licensed practical nurses who have more training than nursing assistants. Agency nurses (D) are temporary nurses hired from external agencies. Unlicensed assistive personnel best fit the description of nurse extenders due to their role in providing direct patient care under supervision.
Which of the following is true regarding health care systems today?
- A. They are all managed care organizations.
- B. They are all privately owned.
- C. Only HMOs are profitable.
- D. There are multiple types of organizations.
Correct Answer: D
Rationale: The correct answer is D because there are indeed multiple types of health care organizations today, including but not limited to managed care organizations, private entities, non-profit organizations, and government-funded systems. This diversity in health care systems allows for different models and approaches to delivering care, catering to the needs and preferences of various populations. Choices A, B, and C are incorrect because not all health care systems are managed care organizations, privately owned, or solely profitable for HMOs. It is essential to understand the complexity and variety in health care systems to provide comprehensive and efficient care to patients.
A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?
- A. Urine is positive for ketones
- B. Urine has an unusual odor
- C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
- D. Bladder scan shows 525 mL of urine
Correct Answer: A
Rationale: The correct answer is A because the presence of ketones in the urine may indicate dehydration or infection, which can lead to catheter obstruction. Irrigation may be needed to clear the catheter and prevent further complications. Choices B, C, and D are incorrect because an unusual odor, high specific gravity, and a significant amount of urine in the bladder do not necessarily indicate the need for catheter irrigation.
How will working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims affect staff?
- A. Feelings of extreme overload.
- B. Fear of failure.
- C. A pessimistic sense about the world.
- D. Inability to separate intense work situations from personal situations.
Correct Answer: B
Rationale: The correct answer is B: Fear of failure. Working in a high-volume, noisy emergency room with a high incidence of assault victims can lead to staff experiencing fear of failure due to the intense and high-pressure nature of the work environment. Staff may feel overwhelmed by the constant influx of critical cases and the need to make quick decisions, which can contribute to a fear of not being able to save every patient. This fear can impact their confidence and increase stress levels.
Incorrect choices:
A: Feelings of extreme overload - While staff may feel overwhelmed, the specific impact mentioned in this choice is not directly related to the work environment described.
C: A pessimistic sense about the world - This choice is too broad and not necessarily tied to the specific challenges of working in this type of emergency room.
D: Inability to separate intense work situations from personal situations - While this can be a challenge, it is not the primary effect discussed in the question stem.