Question

Directions: Select the correct answer to the following questions and provide a rationale for your selection in the spaces provided.  

1. A nurse receives a change-of-shift report at 0700 for an assigned caseload of patients. Number the following patients in the order in which they should be seen:
______ A. A patient who has been receiving a blood transfusion since 0400.
______ B. A patient who has every 4-h PRN analgesic prescription and who last received pain med at 0430.
______ C. A patient who is scheduled for a colonoscopy at 1130 and whose informed consent needs to be verified.
______ D. A patient who needs rapid onset insulin before the breakfast trays arrive.
______ E. A patient who is being discharged today and needs reinforcement of teaching regarding dressing changes.

Rationale:

2. An older adult patient who is on fall preventions is found lying on the floor of his hospital room. Which of the following actions is most appropriate for the nurse to take first?

Call the patient’s provider.

Ask a staff member for assistance getting the patient back to bed.

Inspect the patient for injuries.

Ask the patient why he got out of bed without assistance.

Rationale:

3. An RN on a medical-surgical unit is making assignments at the beginning of the shift. Which of the following tasks
    should the nurse delegate to the LPN?

Obtaining vital signs for a patient who is 2-hour post-procedure following a cardiac catheterization.

Administering a unit of packed red blood cells (CBC).

Instructing a patient in the performance of wound care.

Developing a plan of care for a newly admitted patient.

Rationale:

4. An LPN ending her shift reports to the RN that a newly hired assistive personnel has not calculated the intake and output for several patients. Which of the following actions should the RN take?

Compete an incident report.

Delegate this task to the LPN.

Ask the AP if assistance is needed to complete the I&O records.

Notify the nurse manager.

Rationale:

5. A nurse manager is developing an orientation plan for newly licensed nurses. Which of the following should the manager include in this plan? (Select all that apply.)
____ A. Skill proficiency
____ B. Assignment to a preceptor
____ C. Budgetary principles
____ D. Computerized charting
____ E. Socialization into unit culture
____ F. Facility policies and procedures

Rationale:

6. A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following will provide the most relevant information regarding the efficiency of the procedure?

Frequency with which procedure is performed.

Patient satisfaction with performance of procedure.

Incidence of complications related to procedure.

Accurate documentation of how procedure was performed.  

Rationale:

7. A nurse is hired to replace a staff member who has resigned. After working on the unit for several weeks, the nurse notes that the unit manager does not intervene when there is conflict between team members, even when it escalates. Which of the following conflict resolution strategies is the unit manager demonstrating?

Avoidance

Smoothing

Cooperating

Negotiating

Rationale:

8. A nurse has received a performance appraisal from the unit manager. Which of the following actions by the unit manager required interventions?

The evaluation was conducted in the unit manager’s office.

Data that was collected for the previous 12 months was presented.

Verbal concerns provided by a staff member were incorporated into the data.

The nurse was asked to review the performance appraisal tool and complete a self-evaluation.

Rationale:

9. A nurse who has just assumed the role of unit manager is examining her skills in interprofessional collaboration. Which of the following actions support interprofessional collaboration? (Select all that apply.)
____ A. Use aggressive communication when addressing the team.
____ B. Recognize the knowledge and skills of each member of the team.
____ C. Ensure that a nurse is assigned to serve as the group facilitator for all interdisciplinary meetings.
    ____ D. Encourage the patient and family to participate in the team meeting.
    ____ E. Support team member requests for referral.

Rationale:

10. You are caring for several patients in an acute psychiatric admission war.  
Mr. Canale was admitted for major depression and demonstrates marked psychomotor retardation.  
Ms. Phillips has bipolar disorder and this morning she is very intrusive and loud.  
Mr. Souza was admitted for a severe episode of generalized anxiety disorder and suicidal ideations.  
Ms. Tobin has a long history of anorexia nervosa: she denies suicidal thoughts, but she has attempted suicide in the past. Mr Buchman was admitted for major depression.  

Prioritize the order in which the nurse should address the needs of these patients.
______ Mr. Canale has a bowel movement while sitting in the dayroom, but he will not get up and go to the shower.
______ Ms. Phillips is standing at the nurses’ station yelling at the unit secretary.
______ Mr. Souza appears secretive as he walks down the hall; he is carrying something large under his shirt.
______ Ms. Tobin is doing jumping jacks and jogging around the unit
______ Mr. Buchman is quiet and appears to be on the verge of crying.

Rationale:

Answer 1

2. Inspect the patient for injuries.as he is a patient supposed to be immobilised and advised for complete bed rest and fall prevention. Hence he must be inspected for injuries and then considering these, necessary action must be taken.

3.Obtaining vital signs for a patient who is 2-hour post-procedure following a cardiac catheterization. Because, assessing the patient for normal vitals is necessary to mark him stable. Hence proper bed rest and two hourly assessment would be required.

4. Notify the nurse manager. It is a duty of a nurse to update the OPD and IPD details of newly admitted patients and clearing the data before handing over the duty to the shift nurse.

5.  A. Skill proficiency D. Computerized charting E. Socialization into unit culture F. Facility policies and procedures