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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. How can a staff nurse recognize they are experiencing burnout? (EXCEPT)
- A. They are spending more time talking to staff on other units.
- B. Staff is questioning their clinical judgment.
- C. They sleep longer hours, sometimes coming in late to work.
- D. They are drinking alcohol more frequently to relax.
Correct answer: A
Rationale: Recognizing burnout is essential to maintaining quality patient care. Spending more time talking to staff on other units is a common practice and does not necessarily indicate burnout. On the other hand, staff questioning their clinical judgment, sleeping longer hours or coming in late to work, and resorting to alcohol to relax are signs of burnout. These behaviors can impact patient care and indicate the professional is struggling to cope with stressors.
3. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?
- A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
- B. Incompetence only impacts the individual nurse.
- C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
- D. Most nurse practice acts direct how to handle incompetent nurses.
Correct answer: C
Rationale: Incompetence jeopardizes patient safety. Therefore, the formal process for handling these practices should be followed.
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. How does decision making differ from problem solving?
- A. Decision making always involves selecting from a set of alternatives.
- B. Problem solving always involves selecting one of several alternatives.
- C. Problem solving never involves decision making.
- D. Decision making always involves solving a problem.
Correct answer: A
Rationale: The correct answer is A because decision making always involves selecting from a set of alternatives, while problem solving involves diagnosing a problem. Option B is incorrect as problem solving involves diagnosing a problem rather than selecting one of several alternatives. Option C is incorrect because decision making is often a part of problem-solving processes. Option D is incorrect as decision making may involve selecting from alternatives, not necessarily solving a problem.
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