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1. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?
- A. Blood pressure 144/82 mm Hg
- B. Urine specific gravity 1.03
- C. Neck vein distention
- D. Urine specific gravity 1.01
Correct answer: A
Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.
2. A Manager decides that setting goals will assist her in better utilizing her time. Which of the following are true regarding goal setting in the Manager role?
- A. Goals need to be measurable, realistic, and achievable to be effective.
- B. Writing goals will increase the stress level of the Manager.
- C. Goals should be vague, so they are more likely to be met.
- D. Setting goals is a time waster in the Manager role.
Correct answer: A
Rationale: Setting goals is beneficial for a Manager as they provide direction and save time. Therefore, goals need to be measurable, realistic, and achievable to be effective. Choice B is incorrect as writing goals does not increase stress but rather helps in time management. Choice C is incorrect because vague goals can lead to confusion and lack of clarity. Choice D is also incorrect as setting goals is a productive activity that aids in time management and achievement.
3. An RN�s current patient and family have presented her with an ethical dilemma. What is the first step the RN should take to find a workable solution to the problem?
- A. Planning
- B. Assessment
- C. Evaluation
- D. Implementation
Correct answer: B
Rationale: The first step is assessment and identification of the problem.
4. A client with frequent tonic-clonic seizures is being admitted. What action should the nurse add to the client's plan of care?
- A. Ensure blankets are placed on all four sides of the bed.
- B. Refrain from using restraints during seizure activity.
- C. Position the client laterally during seizure activity.
- D. Have a tongue depressor available at the client's bedside.
Correct answer: D
Rationale: The correct action the nurse should add to the client's plan of care is to have a tongue depressor available at the client's bedside. This is important during a seizure to prevent the client from biting their tongue. Placing the client laterally helps maintain a clear airway and prevents aspiration, making choice C a good practice during seizure activity. Using restraints during a seizure can cause injuries and should be avoided, making choice B incorrect. Wrapping blankets around all four sides of the bed is unnecessary for seizure management and does not contribute to the client's safety during a seizure, making choice A incorrect.
5. In order to minimize or avoid negative outcomes as a result of the violation and disciplinary action, the employee should offer which of the following?
- A. Excuses
- B. Discipline
- C. Suggestions
- D. Rules
Correct answer: C
Rationale: In order to minimize or avoid negative outcomes resulting from a violation and disciplinary action, the employee should offer suggestions. By providing suggestions, the employee demonstrates a willingness to improve and prevent future occurrences. Offering excuses (choice A) may deflect responsibility and not address the issue at hand. Discipline (choice B) is the action taken by the employer, not the employee. Rules (choice D) are guidelines to follow, but in this context, offering suggestions for improvement is more relevant.
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