Lecture 1 "Audience Response" Questions

A nurse manager in a surgical unit finds that many patients are developing UTIs post-operatively and wants to discuss the measures to prevent it with the team. Which action of the nurse manager reflects good communication practice? A. Call the team for a brief meeting B. Text every team member about the problem C. Send a detailed email to the floor staff about preventive measures D. Request the nursing supervisor address all the nursing staff in the facility.

A. Call the team for a brief meeting

The charge nurse would assign the nursing care of which patient to the LPN, working under the supervision of the RN? A. a 48-year-old patient with cystitis who is taking oral antibiotics B. a 64 year old patient with kidney stones who has a new order for lithrotripsy C. a 72 year old with BPH who needs discharge teaching for his tamsulosin D. a 52 year old patient with pyelonephritis who has severe acute flank pain

A. a 48-year-old patient with cystitis who is taking oral antibiotics ("new" = RN; discharge teaching is for the RN; "severe acute pain" = IV pain meds = RN)

The RN is working with an experienced UAP and LPN on the telemetry unit. A patient who had an acute MI3 days ago has been reporting fatigue and chest discomfort when ambulating. Which nursing activity included in the plan of care is best assigned to the LPN? A. administering nitroglycerin 0.4 MG sublingually if chest discomfort occurs B. monitoring HR, BP, and SPO2 before an after patient ambulation C. Teaching the patient energy conservation techniques to decrease myocardial oxygen demand D. explaining the rationale for alternating rest periods with exercise to the patient and family

A. administering nitroglycerin 0.4 MG sublingually if chest discomfort occurs **(C & D require complex teaching that only an RN can do; B is something a UAP can do)**

An experienced LPN, under the supervision of the team leader RN is assigned to provide nursing care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an experienced LPN? Select all that apply A. auscultating breath sounds B. administering medication via meter dose inhaler (MDI) C. Completing an in-depth admission assessment D. checking oxygen saturation using pulse oximetry E. developing the nursing care plan F. evaluating the patient's technique for using MDIs

A. auscultating breath sounds B. administering medication via meter dose inhaler (MDI) D. checking oxygen saturation using pulse oximetry (LPN cannot evaluate, do in-depth teaching, or develop a nursing care plan)

Which patient was the charge nurse assigned to the step down unit nurse who was floated to the intensive care unit for the day? A. a 68-year-old patient on a ventilator with acute respiratory failure and respiratory acidosis B. a 72 year old patient with COPD and normal blood gas values who is ventilator dependent C. A newly admitted 56 year-old patient with diabetic ketoacidosis receiving an insulin drip D. A 38-year-old patient on a ventilator with narcotic overdose and respiratory acidosis

B. a 72 year old patient with COPD and normal blood gas values who is ventilator dependent (B is the answer because they are low acuity & chronic stable; A is acute; C is a high acuity patient)

A newly graduated nurse is assigned to care for a team consisting of herself and a nursing assistant. When delegating skills, she needs to: A. assign only bed making and feeding skills B. assess the knowledge of the nursing assistant C. Remind the nursing assistant that she is working under the license the RN D. allow the nursing assistant to perform any skill that she wants to

B. assess the knowledge of the nursing assistant (we do not know the experience of the nursing assistant and need to assess for further info)

A patient received PRN morphine, lorazepam, and cyclobenzaprine. The UAP reports that the patient has a respiratory rate of 10 breaths per minute. What is the priority action? A. call the healthcare provider to obtain an order for naloxone B. assess the patient's responsiveness and respiratory status C. Obtain a bag valve mask and delivered breaths at 20 breaths per minute D. double check the HCP orders to see which drugs were ordered

B. assess the patient's responsiveness and respiratory status (nursing process)

The nurse manager noticed that one of the staff nurses is giving excuses for performing one task on time but ignoring another assigned task. What does the nurse manager do in the situation? A. penalize the nurse for this behavior B. identify the reason for procrastination C. Recommend the nurse not do the task D. recommend nurse to leave least attractive elements of an assignment for last

B. identify the reason for procrastination (nursing process--assess)

A nurse can specialize in nursing education. What is the name of the formal process to obtain recognition for expertise in the specialty area? A. licensure B. accreditation C. Certification D. authorization

C. Certification

The nurse admits for patients with infections to the medical unit, but only one private room is available. Which patient is most appropriate to assign to private room? A. patient with diarrhea caused by C. Diff B. patient with VRE infection C. Patient with a cough who may have active TB D. patient with toxic shock syndrome and fever

C. Patient with a cough who may have active TB

A home health nurse is caring for a 72-year-old patient who has a stage two pressure ulcer, with risk factors of poor nutrition, bladder incontinence, and limited mobility. Which nursing action should be delegated to the UAP? A. tell him the patient and family to apply the skin barrier cream in a smooth, even layer B. completing a diet assessment and suggesting increasing protein intake C. Reminding the family to help the patient to the commode every two hours during the day D. observing and measuring the patient's pressure ulcer each week

C. Reminding the family to help the patient to the commode every two hours during the day

The nurse has just finished assisting the healthcare provider with a thoracentesis for a patient with recurrent left plural effusion caused by lung cancer. The thoracentesis removed 1800 ML of fluid. Which patient assessment information is most important to report to the healthcare provider? A. the patient starts crying and says she can't go on with treatment much longer B. the patient reports sharp, stabbing chest pain with every deep breath C. The blood pressure is 100/48, and the heart rate is 102 BPM D. the dressing of the thoracentesis site is 1 cm of bloody drainage

C. The blood pressure is 100/48, and the heart rate is 102 BPM (C = fluid shift/hypovolemia)

The nurse manager observes that the nurses in the unit take breaks during their shift longer than the organization policy of 15 minutes. What is the best action of the nurse manager? A. the nurse manager should appoint a nurse to keep a check on the brakes taken by the nurses B. The nurse manager should impose a monetary fine on the nurses for taking long breaks C. The nurse manager should keep their break limited to 15 minutes D. the nurse manager should discuss a solution to the issue with the primary healthcare provider

C. The nurse manager should keep their break limited to 15 minutes (lead by example)

The nurse manager in a cancer facility notes that the nursing care team is demotivated due to consecutive deaths of two terminally ill cancer patients. Which action of the nurse manager would help renew the teams energy? A. counseling the team members that death is an inevitable part of chronic disease/illnesses B. Shifting the team to another nursing unit with less likelihood of deaths occur in C. Instructing the team members to be emotionally detached from the patients they care for D. arranging a notice board in the unit and posting photos or messages reflecting achievements of the team

D. arranging a notice board in the unit and posting photos or messages reflecting achievements of the team

When the nurse is monitoring a 53-year-old patient who is undergoing a treadmill stress test, which finding will require the most immediate action? A. blood pressure 152/88 B. heart rate 134 BPM C. Oxygen saturation 91% D. chest pain 3/10

D. chest pain 3/10 (the nurse should immediate stop the stress test if patient is having active CP)

Which actions can the school nurse delegate to an experience UAP who is working with a seven-year-old child with type one diabetes in an elementary school? Select all that apply A. obtaining information about the child's usual insulin use from the parents B. administering prescribed insulin with lunch C. Teaching the child about what foods have high carbohydrate levels D. reporting the child's blood glucose readings that the child obtain from his monitor E. reminding the child to have a snack after the physical education class F. assessing the child's knowledge level about his or her type one diabetes

D. reporting the child's blood glucose readings that the child obtain from his monitor E. reminding the child to have a snack after the physical education class

The nurse is caring for a patient who was recently admitted for severe diverticulitis. Which task is appropriate to delegate or a sign for the care of this patient? A. tell the unit secretary to call radiology and schedule a barium enema B. ask the LPN to give a PRN laxative if the patient reports constipation C. Instruct the nursing student to help the patient ambulate up and down the halls D. tell the UAP to save a stool specimen to test for occult blood

D. tell the UAP to save a stool specimen to test for occult blood (A,B,C are not appropriate for DX of diverticulitis)