PrepU Professional Behaviors/ Professionalism (from Quiz 4)

In the emergency department, a client with facial lacerations states that her husband beat her with a shoe. After her lacerations are repaired, the client waits to be seen by the crisis intake nurse, who will evaluate the continued threat of violence her husband represents. Suddenly the client's husband arrives, shouting that he wants to "finish the job." What is the first priority of the nurse who witnesses this scene? a) Calling a security guard and another staff member for assistance b) Remaining with the client and staying calm c) Telling the client's husband that he must leave at once d) Determining why the husband feels so angry

a) Calling a security guard and another staff member for assistance Rationale: The nurse who witnesses this scene must take precautions to ensure personal as well as client safety, but shouldn't attempt to manage a physically aggressive person alone. Therefore, the first priority is to call a security guard and another staff member. After doing this, nurse should inform the husband what is expected, speaking in concise statements and maintaining a firm but calm demeanor. This approach makes it clear that the nurse is in control and may defuse the situation until the security guard arrives. Telling the husband to leave would probably be ineffective in his agitated and irrational state. Exploring his anger doesn't take precedence over safeguarding the client and staff.

A nurse is caring for a patient with acute renal failure and hypernatremia. Which of the following actions can be delegated to the nursing assistant? a) Provide oral care every 2-3 hours. b) Teach the patient about increased fluid intake. c) Assess the patient's daily weights for trends. d) Monitor for signs and symptoms of dehydration.

a) Provide oral care every 2-3 hours. Rationale: Providing oral care for the patient every 23 hours is within the scope of practice of a nursing assistant. The other actions should be completed by the registered nurse.

A client with a history of type 1 diabetes is admitted to the hospital with community-acquired pneumonia. The client's blood glucose level in the emergency care unit was 576 mg/dl (31.97 mmol/L). The physician orders an I.V. containing normal saline solution, an insulin infusion, and I.V. levofloxacin. The nurse piggybacks the insulin infusion into the normal saline solution. She questions whether she can also piggyback the levofloxacin into the same I.V. line. Which health team member should she collaborate with to check the compatibility of these solutions? a) The pharmacist covering the floor b) The physician who ordered the medications c) The infectious disease nurse d) The coworker with 20 years of nursing experience

a) The pharmacist covering the floor Rationale: The nurse should collaborate with the pharmacist covering the floor for drug compatibility information. The physician ordering the drug, the experienced coworker, and the infectious disease nurse aren't experts in drug compatibility issues.

A nurse-manager for a community health organization is planning for the home health needs of an 8-year-old child who requires around-the-clock care by nursing assistants. The nurse-manager knows that when working with a nursing assistant, she must: a) ensure that the work is divided equitably to prevent staff burnout and rapid turnover. b) provide written instructions, education, and ongoing supervision. c) ensure that the nursing assistant is paid fairly and for any additional time worked. d) in the event of limited staff resources, provide health services to those in greatest need.

b) provide written instructions, education, and ongoing supervision. Rationale: When working with a nursing assistant, the nurse-manager must provide written instructions, education, and ongoing supervision. Although the nurse-manager should be concerned with the equitable division of work and proper payment for hours worked, these concerns aren't the highest priorities. The provision of health services to those in greatest need is an important overall goal, but isn't specific to working with a nursing assistant.

Students are reviewing information about community health nursing. The students demonstrate understanding of the term "community-oriented nursing practice" by describing it as which of the following? a) Nursing care directed to specific client groups with identified needs, usually related to illness b) Provision of primary care services, often with care being provided to underserved populations c) Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups d) Nursing care of clients with complex needs who are discharged from acute care institutions early in the recovery process

c) Nursing interventions that can promote wellness, reduce illness spread, and improve the health status of groups Rationale: Community-oriented nursing practice focuses on nursing interventions that can promote wellness, reduce the spread of illness, and improve the health status of groups of citizens or the community at large. Community-based nursing and home health care is directed toward specific client groups with identified needs, which usually relate to illness, injury, or disability, resutling most often from advanced age or chronic illness. Community nursing centers are nurse managed and provide primary care, often to underserved populations. Home care nursing is a specialty area that provides care in the home and community to meet the needs of clients who are discharged from acute care institutions to their homes and communities early in the recovery process and with complex needs.

A nurse on a telemetry unit is admitting a client and has an unlicensed assistive person (UAP) helping with the admission process. Which task can the nurse delegate to the UAP? a) Listing the client's home medications on a medication reconciliation form b) Gathering information about the client's medical history and any allergies c) Obtaining an admission weight for the client utilizing the client's bed scale d) Determining what heart rhythm the client is in based on telemetry reading

c) Obtaining an admission weight for the client utilizing the client's bed scale Rationale: The nurse should delegate obtaining the initial weight to the UAP, as this is within the capability of the UAP. The task of obtaining a history, including home medications, is a responsibility of the nurse with documentation in the medical record. The nurse should also interpret the initial rhythm of the client. Although UAPs may be able to interpret the rhythm based on special training, there is no indication of this being true for the UAP in the scenario and the nurse should still verify the initial rhythm interpretation is correct.

A newly hired elementary school health nurse is reviewing the job description. Which of the following activities can the school nurse expect to perform in this new role? Select all that apply. a) Establishing an Alcoholics Anonymous chapter b) Educating teachers about HIV c) Providing minor first aid d) Organizing a visit from the mobile dentist e) Writing curriculum related to effects of chemotherapy f) Developing a suicide risk assessment tool

c) Providing minor first aid b) Educating teachers about HIV d) Organizing a visit from the mobile dentist e) Writing curriculum related to effects of chemotherapy Rationale: The leading health problems of elementary school children are injuries, infections, malnutrition, dental disease, and cancer. Alcohol and drug abuse, mental/emotional problems, and suicide are leading health problems for high school students.

The health care provider prescribes orders for a client with newly diagnosed uncontrolled seizure activity. When reviewing the prescriptions, the nurse correctly identifies which prescription, if followed, puts him at risk for negligence charges? a) Neurologic assessments every 5 minutes b) Diazepam (Valium) 5 mg intravenously now c) Restrain all four extremities d) Oxygen 2/L via nasal cannula

c) Restrain all four extremities Rationale: The nurse is obligated to carry out health care provider?s orders unless it is unclear or incorrect. The client with seizures must be protected from harm. Restraints restricts the client?s movement and can cause harm. Diazepam, oxygen, and frequent neurologic assessments are correct interventions for a client with uncontrolled seizure activity.

A nurse who is 6 months pregnant is assigned to a client with a diagnosis of HIV. The nurse tells the manager that she is unable to care for the client because it would be a risk to her baby. Which of the following is the most appropriate statement by the manager? a) "You can decrease the risk of exposure to the virus if the client uses disposable plates and utensils when eating." b) "There will be no problem with this assignment if you wear a mask and gloves while providing all direct client care." c) "I will ask that you be transferred to another unit while you are pregnant so there is no risk to you or your baby." d) "You will be OK if you follow standard precautions and use protective equipment to avoid contact with blood and body fluids when providing care."

d) "You will be OK if you follow standard precautions and use protective equipment to avoid contact with blood and body fluids when providing care." Rationale: By following standard precautions and using personal protective equipment when exposed to or handling blood or body fluids there should be no risk of exposure. The other options are either ineffective or not necessary when caring for a client who is HIV positive.