Management of Care (HESI)
A psychiatric nurse is working at a community mental health clinic. Which activity demonstrates that the nurse knows the importance of engaging in effective self-awareness?
Accepting a client's decision to refuse electroconvulsive therapy as a treatment for chronic depression Effective self-awareness is demonstrated by an accepting attitude toward clients' values, beliefs, and decisions when they differ from our own. Although formal religion is a source of happiness for many, it is not an important component of life for everyone. Biases are not acted upon when a nurse is effectively self-aware. Cultural awareness is a component of good nursing practice. Knowledge of cultural practices in and of itself is not a reflection of acceptance, which is a necessary component of self-awareness. Seeking alternative points of view is a characteristic of effective self-awareness because it aids in the acceptance of differing viewpoints.
The nurse manager found that the nursing assistant (NA) shows unwillingness and is not motivated to go beyond the job description to take care of a client during the night. Which strategy by the nurse leader would motivate the NA and create job satisfaction?
Ask the nursing assistant (NA) to participate in decision making. According to the two-factor theory of leadership, motivating factors such as recognition and satisfaction of work promote job enrichment and create job satisfaction. Hygiene factors such as recruiting more staff to balance the work for nursing assistants (NAs), increasing the NA's salary, and increasing the security needs at night only avoid job dissatisfaction; these factors do not necessarily motivate the NA.
The nurse is assessing clients who have sustained submersion injuries. Which are most likely to be the nurse's assessment findings? Select all that apply.
Rhonchi Cough with pink-frothy sputum Ronchi and cough with pink-frothy sputum are common pulmonary assessment findings in submersion victims. The absence of reflexes is associated with hypothermia, not necessarily submersion. Hypotension, not hypertension, is a common assessment finding associated with submersion injuries. Fixed, dilated pupils are associated with victims of hypothermia.
A registered nurse is teaching a nursing student about Healthcare Effectiveness Data and Information Set (HEDIS). Which point mentioned by the student post-teaching needs correction?
"Healthcare Effectiveness Data and Information Set (HEDIS) conducts surveys via a randomly selected sample of adults who were discharged from a hospital between 48 hours and 6 weeks ago." The Hospital Consumer of Assessment of Healthcare Providers and Systems (HCAHPS) is a survey that is conducted by randomly selecting samples of adults who were discharged from a hospital between 48 hours and six weeks ago. Healthcare Effectiveness Data and Information Set (HEDIS) is relied upon by health plans throughout the United States as a quality measure. HEDIS is the database of choice for the Centers for Medicare and Medicaid Services (CMS). HEDIS was created by the National Committee for Quality Assurance (NCQA) to collect data to measure the quality of care and services provided by different health plans
The nurse is questioning a client who reports pain. Which questions asked by the nurse are appropriate? Select all that apply.
"Where does it hurt?" "What makes the pain worse?" "How long have you noticed it?" "How severe is your pain on a scale of 0 to 10?" The nurse should follow an orderly and systematic approach when collecting information. The nurse should ask specific questions of the client such as "Where does it hurt?", "What makes the pain worse?", "How long you have noticed it?" and "How severe is your pain on a scale of 0 to 10?" Questions such as "Have you been treated for pain previously?" should be asked after understanding the characteristics of the pain.
A child in sickle cell crisis is admitted to the pediatric unit. Which actions will the nurse take? Select all that apply.
Administer hydroxyurea Apply oxygen via nasal cannula Offer age-appropriate activities Administer intravenous (IV) hydration Hydroxyurea can reduce the number of sickling and pain episodes by stimulating fetal hemoglobin production. Providing oxygen via nasal cannula provides additional oxygen, which is necessary because of decreased hemoglobin, which carries oxygen. Age-appropriate activities can help alleviate boredom as the child begins to feel better. Providing intravenous hydration until the child is able to tolerate adequate by mouth fluids reduces sickle cell clotting. Strict isolation is not necessary. Aspirin should not be given to children because of risk of Reye syndrome.
A 4-year-old child with a new colostomy is to be discharged in several days. What should the nurse teach the parents about their child's home care?
Encouraging physical activity Contact games may be restricted, but other physical activities should be encouraged. The stoma should be inspected more often than once daily to ensure adequate circulation. Increased fluid intake is needed to compensate for fecal fluid loss. The diet should not be restricted at the time of discharge. Both the parents and the child will learn which foods are poorly tolerated, and they will adjust the diet accordingly.
