Nokea
You are the nurse manager of the surgical acute care unit. You have noticed that several clients have almost been sent to the preoperative suite when they are not scheduled for a planned surgical procedure. Fortunately, no clients have gotten a 'wrong surgery' because this possible error was caught in time. What is your priority action as the nurse manager?
- A. Praise the staff for catching these near misses before a surgical error occurs.
- B. Investigate and explore this near miss.
- C. Investigate and explore this medical error.
- D. Report the nature and frequency of these medical errors to the State Department of Health.
Correct Answer: B
Rationale: Investigating and exploring the near miss (B) is the priority to identify root causes and prevent future errors. These are near misses, not medical errors (C, D), as no harm occurred. Praising staff (A) is supportive but secondary to addressing the systemic issue.
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The nurse is caring for the following assigned clients. It would be a priority to follow up with a client who
- A. is being treated for acute glomerulonephritis (AGN) and has periorbital edema.
- B. has urolithiasis and reports persistent nausea.
- C. is receiving continuous bladder irrigation and reports the need to void.
- D. just returned from a hemodialysis session and reports dizziness.
Correct Answer: D
Rationale: Dizziness post-hemodialysis (D) suggests hypotension or fluid shifts, a life-threatening complication requiring immediate follow-up. Edema in AGN (A), nausea with urolithiasis (B), and voiding sensation with irrigation (C) are less urgent.
The nurse is caring for a client who has just returned from receiving a hemodialysis treatment. It would require immediate follow-up by the nurse if the client has
- A. a temperature (T) of 99.4°F (37.4°C).
- B. restlessness and a headache.
- C. weight loss of 3 kilograms (6.6 pounds).
- D. persistent fatigue.
Correct Answer: B
Rationale: Restlessness and headache post-hemodialysis (B) suggest disequilibrium syndrome or hypotension, critical complications requiring immediate follow-up. Mild fever (A), weight loss (C), and fatigue (D) are expected or less urgent.
The nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which of the following activities would be appropriate to delegate? Select all that apply.
- A. Performing initial client assessments
- B. Making client beds
- C. Giving clients bed baths
- D. Administering client medications
- E. Ambulating clients
- F. Assisting clients with meals
Correct Answer: B, C, E, F
Rationale: UAPs can make beds (B), give bed baths (C), ambulate clients (E), and assist with meals (F), as these are non-clinical tasks. Initial assessments (A) and medication administration (D) require nursing judgment, reserved for RNs or LPNs.
The nurse is planning to interview a client interested in establishing care with a primary healthcare provider (PHCP). The nurse should initially
- A. obtain the client's vital signs.
- B. identify the client's chief complaint.
- C. provide a private area for the interview.
- D. inquire about the client's allergies.
Correct Answer: C
Rationale: Providing a private area (C) ensures confidentiality and comfort, the initial step for an interview. Chief complaint (B), allergies (D), and vital signs (A) follow after establishing privacy.
The charge nurse is planning client care assignments for a licensed practical/vocational nurse (LPN/VN). Which of the following would be an appropriate assignment(s) for the LPN? Select all that apply.
- A. A 67-year-old one-hour post-procedure from a cardiac catheterization.
- B. An 88-year-old client who was just admitted for intractable pain secondary to metastatic cancer.
- C. A 42-year-old being discharged following a diagnosis of type 2 diabetes mellitus.
- D. A 75-year-old inpatient client with colon cancer needing colostomy care.
- E. A 50-year-old client being treated for herpes zoster with prescribed oral antivirals.
Correct Answer: B, D, E
Rationale: LPNs can manage stable clients with pain (B), colostomy care (D), and oral antivirals (E) within their scope. A client one-hour post-cardiac catheterization (A) requires RN monitoring for complications, and discharge teaching for diabetes (C) involves complex education best suited for an RN.