Nursing Elites

1. Which of the following is an organizational factor that affects workplace violence directed at nurses?

• A. Clients who have short hospital stays
• B. The presence of security guards
• C. Restricted client areas
• D. Understaffing of nursing personnel

Correct answer: D

Rationale: Understaffing of nursing personnel is a critical organizational factor that can contribute to workplace violence directed at nurses. When there are too few nurses on duty due to understaffing, it can lead to delays in care delivery and inadequate attention to clients' needs. This situation can result in heightened frustration, aggression, or violence from clients or their families towards the nursing staff. On the other hand, the presence of security guards (Choice B) may enhance safety in the workplace and deter violence, making it an incorrect choice. Clients who have short hospital stays (Choice A) and restricted client areas (Choice C) are not directly linked to organizational factors that promote workplace violence against nurses, making them incorrect choices.

2. A registered nurse who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN?

• A. A middle-aged client who says, "I took too many diet pills"? and "my heart feels like it is racing out of my chest."?
• B. A young adult who says, "I hear songs from heaven. I need money for beer. I quit drinking two (2) days ago for my family. Why are my arms and legs jerking?"?
• C. An adolescent who has been on pain medications for terminal cancer with an initial assessment finding of pinpoint pupils and a relaxed respiratory rate of 11.
• D. An elderly client who reports having taken a "large crack hit"? 10 minutes prior to walking into the emergency room.

Correct answer: C

Rationale: When assigning a floated nurse from another unit to a client in the emergency department, the goal is to choose a patient with minimal anticipated immediate complications. In this scenario, the adolescent with terminal cancer who has been on pain medications and presents with pinpoint pupils and a relaxed respiratory rate of 11 is the most stable option. These assessment findings indicate opioid toxicity, which, while serious, has the least risk of immediate complications compared to the other clients. Choice A involves a middle-aged client experiencing symptoms of possible cardiac issues due to diet pill overdose, which requires urgent intervention. Choice B presents a young adult with concerning symptoms of potential psychosis or substance withdrawal, requiring immediate attention. Choice D involves an elderly client who recently used crack, posing a high-risk situation that requires prompt evaluation and intervention. Therefore, the correct choice is the adolescent with opioid toxicity, as this client has the least immediate risk of complications among the options provided.

3. As a valued member of the team on your nursing care unit, you are trying to determine whether the team is doing well. Which of the following is a sign that your team is successful?

• A. Conflict occurs but is seen as an opportunity for team growth and development.
• B. No negative feelings are expressed, leading to everyone being happy and satisfied.
• C. Mistakes are not tolerated and result in disciplinary action.
• D. People avoid taking risks and stick to the status quo.

Correct answer: A

Rationale: One of the key indicators of a successful team is the ability to handle conflict positively. Conflict, when managed well, can lead to team growth and development. Choice B is incorrect because suppressing negative feelings does not indicate team success; open communication is crucial. Choice C is incorrect as successful teams view mistakes as learning opportunities rather than resorting to disciplinary action. Choice D is incorrect because successful teams are often innovative and willing to take risks rather than maintaining the status quo.

4. Which of the following is an example of emotional abuse?

• A. A slap to the person's hand
• B. Threatening the person
• C. Ignoring and isolating a person
• D. Leaving a patient soiled for hours

Correct answer: C

Rationale: Emotional abuse involves behaviors that harm an individual's self-worth and emotional well-being. Threatening someone instills fear and causes psychological distress, making it a clear example of emotional abuse. Choices A, C, and D involve physical abuse, neglect, and neglect of care, respectively, rather than emotional abuse. A slap to the person's hand constitutes physical abuse, ignoring and isolating a person is neglectful behavior, and leaving a patient soiled for hours falls under neglect of care.

5. You are preparing to admit a patient with a seizure disorder. Which of the following actions can you delegate to an LPN/LVN?

• A. Complete admission assessment.
• B. Set up oxygen and suction equipment.
• C. Place a padded tongue blade at the bedside.
• D. Pad the side rails before the patient arrives.

Correct answer: B

Rationale: The correct answer is to delegate the task of setting up oxygen and suction equipment to the LPN/LVN. This task falls within their scope of practice and can be safely performed by them. Completing the admission assessment (Choice A) typically requires a higher level of assessment and critical thinking, making it more appropriate for a registered nurse. Placing a padded tongue blade at the bedside (Choice C) involves potential airway management, which is a more complex task and should be done by a higher-level provider. Padding the side rails before the patient arrives (Choice D) is a task related to patient safety and should be done by the healthcare team as a whole, not solely delegated to an LPN/LVN.

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