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1. When a client who is in pain refuses to be repositioned, what should the nurse consider first in making a decision about what to do?
- A. Why a decision is needed.
- B. Who actually gets to make the decision?
- C. What are the alternatives?
- D. When a decision is needed.
Correct answer: A
Rationale: In this scenario, the nurse should first consider why a decision is needed. Understanding the underlying reason for the decision helps in selecting the best action to meet the desired goal. Who actually makes the decision is important but not the primary consideration. Exploring alternatives comes after determining the reason for the decision, who makes it, and when it is needed.
2. Which of the following is a common characteristic of a high-performing healthcare team?
- A. Effective communication
- B. Shared leadership
- C. Collaborative decision making
- D. Hierarchical structure
Correct answer: C
Rationale: Collaborative decision making is a key characteristic of a high-performing healthcare team because it involves team members working together to make decisions that lead to the best outcomes for patients. Effective communication is important in any team, but collaborative decision making goes beyond communication by involving team members in the decision-making process. Shared leadership is also crucial for a high-performing team, as it promotes equality and empowerment among team members. On the other hand, a hierarchical structure can hinder effective communication and teamwork by creating barriers between team members and limiting input from all team members, which is counterproductive to achieving optimal healthcare outcomes.
3. When lifting a bedside cabinet to move it closer to a client, what action should the nurse take to prevent self-injury?
- A. Keep the feet close together.
- B. Use the back muscles for lifting.
- C. Stand close to the cabinet when lifting it.
- D. Bend at the waist.
Correct answer: A
Rationale: The correct answer is A: 'Keep the feet close together.' When lifting a heavy object such as a bedside cabinet, it is essential to maintain a wide base of support by keeping the feet close together. This provides better stability and reduces the risk of injury. Choice B is incorrect because using the back muscles for lifting can lead to back strain and injury; it is recommended to use the legs instead. Choice C is incorrect as standing close to the cabinet may cause the nurse to lose balance and strain the back. Choice D is incorrect because bending at the waist increases the risk of back injury. Therefore, the safest and most appropriate action is to keep the feet close together to ensure stability and prevent self-injury.
4. Why is increasing the use of advanced practice nurses encouraged?
- A. A 2010 Institute of Medicine report recommended nurses practice to the full extent of their education.
- B. Advanced practice nurses act as an extension of physicians.
- C. The National League for Nursing advocates for the master of science in nursing (MSN) as the terminal degree for nurse practitioners.
- D. Advanced practice nurses lack the skills to diagnose.
Correct answer: A
Rationale: The correct answer is A because the 2010 Institute of Medicine report recommended that nurses practice to the full extent of their education, which includes utilizing advanced practice nurses. This supports the efficient delivery of healthcare services by leveraging the expertise and skills of advanced practice nurses. Choice B is incorrect as it describes the role of advanced practice nurses rather than providing a reason for increasing their use. Choice C is unrelated to the encouragement of increasing the use of advanced practice nurses as it focuses on the terminal degree for nurse practitioners. Choice D is incorrect as advanced practice nurses do possess the skills necessary to diagnose and provide advanced care, so the statement that they lack diagnostic skills is inaccurate.
5. During a home safety assessment, a nurse is evaluating a client who is receiving supplemental oxygen. Which observation should the nurse identify as a proper safety protocol?
- A. The client has a weekly inspection checklist for oxygen equipment.
- B. The client stores an extra oxygen tank on its side under their bed.
- C. The client identifies the location of a fire extinguisher.
- D. The client uses a wool blanket on their bed.
Correct answer: A
Rationale: The correct answer is A because having a weekly inspection checklist for oxygen equipment ensures that the client can monitor the safety and functionality of the oxygen equipment regularly. This is crucial for maintaining a safe environment. Choice B is incorrect because storing an extra oxygen tank on its side under the bed can pose a safety hazard, as tanks should be stored upright. Choice C is a good safety practice, but it is not directly related to oxygen use. Choice D is incorrect because wool blankets are flammable and should not be used by clients receiving supplemental oxygen due to the increased risk of fire.
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