Nokea
Which statement made by an RN regarding delegation indicates the need for additional teaching? (select all that apply)
- A. Unlicensed assistive personnel (UAP) can assess vital signs during the first 5 minutes for a patient who is receiving a blood transfusion because a reaction at this time is unlikely.
- B. An LPN/LVN can administer a PPD (tuberculin skin test) if there is no history of a positive PPD.
- C. When dopamine is ordered continuously, the LPN/LVN can administer dopamine at a low dose for the purpose of increasing renal perfusion.
- D. UAPs can transfer a patient who is being discharged home from the wheelchair to the bed if they have received training and demonstrated competency.
Correct Answer: A
Rationale: The correct answer is A. Delegating the assessment of vital signs during the first 5 minutes of a blood transfusion to UAPs is not appropriate. This is because a reaction can occur within the first few minutes of a blood transfusion, making it crucial for a registered nurse to assess the patient during this critical period. UAPs do not have the education or training to recognize and manage potential adverse reactions promptly.
Choice B is incorrect because an LPN/LVN can indeed administer a PPD if there is no history of a positive result. Choice C is incorrect because LPN/LVNs should not administer medications that have a high potential for adverse effects, such as dopamine. Choice D is incorrect as transferring a patient who is being discharged home requires skilled nursing assessment and intervention, not just training in transferring techniques.
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The key to organizational success for health care facilities is:
- A. hiring younger, more energetic nurses.
- B. offering incentives such as sign-on bonuses.
- C. hiring highly qualified advanced practice nurses.
- D. retaining professional nurses.
Correct Answer: D
Rationale: The correct answer is D: retaining professional nurses. Retaining professional nurses is crucial for organizational success in healthcare facilities as it ensures continuity of care, promotes staff morale, reduces turnover costs, and maintains high-quality patient outcomes. By retaining experienced and skilled nurses, organizations can benefit from their expertise, knowledge, and commitment to providing excellent patient care.
A: Hiring younger, more energetic nurses may bring new perspectives and energy but does not guarantee the same level of experience and expertise as professional nurses.
B: Offering incentives like sign-on bonuses may attract new hires, but it does not address the underlying issues that lead to nurse turnover.
C: Hiring highly qualified advanced practice nurses is beneficial, but it does not address the importance of retaining all professional nurses within the organization.
A group of nurses are interested in the how to improve teaching effectiveness for patients who have a hearing impairment and lack family involvement while hospitalized. They believe "hearing loss decreases the teaching effectiveness while hospitalized." The group plans to evaluate teaching effectiveness using a 10-point Likert scale pre-post teaching, perform a hearing test to determine degree of hearing loss on admission, and have social work evaluate the impact of hearing impairment on patient's ability to safely live alone prior to discharge. The group is working in which step of the scientific process?
- A. Hypothesis
- B. Method
- C. Results
- D. Evaluation
Correct Answer: B
Rationale: The correct answer is B: Method. In the scientific process, the method refers to designing and planning the research study. In this scenario, the group of nurses is planning how to improve teaching effectiveness for patients with hearing impairment, which involves designing the study by using a Likert scale pre-post teaching evaluation, conducting a hearing test, and involving social work for evaluation. This step focuses on determining how the research will be carried out, including data collection methods and procedures. The other choices are incorrect because:
A: Hypothesis - This step involves formulating a testable prediction based on observations or existing knowledge.
C: Results - This step involves analyzing the data collected and drawing conclusions.
D: Evaluation - This step involves assessing the effectiveness or outcomes of the research study.
Diagnosis-related groups (DRGs) have attempted to reduce health care costs by decreasing:
- A. hospital admission rates.
- B. length of hospital stay.
- C. outpatient services.
- D. specialty groups.
Correct Answer: B
Rationale: The correct answer is B: length of hospital stay. DRGs aim to reduce healthcare costs by incentivizing hospitals to provide efficient care and discharge patients sooner. Shortening the length of hospital stay helps decrease overall healthcare expenses without compromising the quality of care. Choices A, C, and D are incorrect because DRGs focus on the duration of hospitalization, not necessarily on hospital admission rates, outpatient services, or specialty groups. Shortening hospital stays is a more direct way to control costs within the inpatient setting.
A pregnant woman reports back pain and wants to try a complementary alternative medicine (CAM) therapy. The nurse knows that which CAM would be contraindicated?
- A. Magnet therapy
- B. Aromatherapy
- C. Imagery
- D. Therapeutic touch
Correct Answer: A
Rationale: The correct answer is A: Magnet therapy. Magnet therapy is contraindicated in pregnancy due to the risk of unknown effects on the fetus. Magnets may interfere with the body's natural magnetic fields, potentially causing harm to the developing baby. Aromatherapy (B), imagery (C), and therapeutic touch (D) are generally considered safe during pregnancy when performed by trained professionals and with appropriate precautions. Aromatherapy uses essential oils, imagery involves mental visualization techniques, and therapeutic touch uses energy-based techniques that do not pose significant risks to the pregnant woman or the fetus.
The nurse prepares to apply sterile gloves needed for a procedure. After introducing self and verifying patient information, the nurse performs hand hygiene. The nurse should open the outer package and then perform the following steps in order: (items on left will be moved in correct order on the right) Open inner package, taking care not to touch inner surface. Put the glove on the nondominant hand using the sterile gloved hand. Put glove on dominant hand by grasping folded cuff edge, touching only inside of cuff. Adjust each glove carefully by sliding finders under the cuffs. The above question represents which type of alternate-format question written at which level of Bloom's taxonomy?
- A. Drag-and-drop item, comprehension
- B. Chart/exhibit item, analysis
- C. Multiple-response, application
- D. Hot-spot item, knowledge
Correct Answer: A
Rationale: The correct answer is A: Drag-and-drop item, comprehension. This question requires the nurse to demonstrate understanding of the correct sequence for applying sterile gloves. The drag-and-drop format assesses the ability to organize steps in a specific order, which falls under the comprehension level of Bloom's taxonomy, where the individual is required to understand the information provided. The other choices are incorrect because:
B: Chart/exhibit item, analysis - This choice involves interpreting data or information presented in a chart or exhibit, which is not the case in this question.
C: Multiple-response, application - This choice requires selecting multiple correct responses to a scenario, which is not the format of this question.
D: Hot-spot item, knowledge - This choice involves identifying a specific area or point on an image, which is not relevant to the question about the correct sequence for applying sterile gloves.