Nursing Elites

1. At a nursing staff meeting, there is a discussion of perceived inequities in weekend staff assignments. As a follow-up, what should the nurse manager do initially?

• A. Allow the staff to change assignments
• B. Clarify reasons for current assignments
• C. Help staff see the complexity of issues
• D. Facilitate creative thinking on staffing

Correct answer: D

Rationale: Facilitating creative thinking on staffing is the most appropriate initial action for the nurse manager in addressing perceived inequities in weekend staff assignments. By encouraging creative thinking, the manager promotes innovative solutions and fosters a sense of ownership and collaboration among staff members. Choices A, B, and C are not the best initial steps in this situation. Allowing staff to change assignments may not address the underlying issues, clarifying reasons for current assignments may not resolve perceived inequities, and helping staff see the complexity of issues may not lead to actionable solutions.

2. The nurse is working in a community health clinic that serves a diverse population. Which of the following actions best demonstrates cultural competence?

• A. Learning about the cultural practices of the clinic's client population
• B. Providing translation services for non-English speaking clients
• C. Treating all clients the same regardless of their background
• D. Encouraging clients to adopt mainstream health practices

Correct answer: A

Rationale: Learning about the cultural practices of the clinic's client population is the best way to demonstrate cultural competence. This action shows respect for the diverse backgrounds of the clients and helps in providing care that is sensitive to their cultural beliefs and practices. Providing translation services (Choice B) is important for effective communication but may not address the deeper aspects of cultural competence. Treating all clients the same (Choice C) may overlook the unique needs that arise from cultural differences. Encouraging clients to adopt mainstream health practices (Choice D) may not be appropriate or respectful of their cultural traditions and preferences.

3. The nurse is assessing a 12-year-old who has Hemophilia A. Which finding would the nurse anticipate?

• A. An excess of red blood cells
• B. An excess of white blood cells
• C. A deficiency of clotting factor VIII
• D. A deficiency of clotting factors VIII and IX

Correct answer: C

Rationale: The correct answer is C: A deficiency of clotting factor VIII. Hemophilia A is characterized by a lack of clotting factor VIII, which is crucial for blood clotting. This deficiency results in prolonged bleeding. Choices A, B, and D are incorrect. There is no association between Hemophilia A and an excess of red blood cells (Choice A) or an excess of white blood cells (Choice B). Additionally, Hemophilia A specifically involves a deficiency of clotting factor VIII, not both factors VIII and IX (Choice D).

4. As community health nurses engage in the process of community empowerment, it is essential that they:

• A. gather data from the community
• B. form partnerships with people in the community
• C. make decisions for the people in the community
• D. accept responsibility for people's actions

Correct answer: B

Rationale: In the process of community empowerment, community health nurses should form partnerships with the community rather than making decisions for them, gathering data alone, or accepting responsibility for their actions. Forming partnerships ensures that the community is actively involved in decision-making processes, leading to sustainable and effective outcomes. Gathering data is important but not the central aspect of empowerment, while accepting responsibility for people's actions is not a core principle of empowerment but rather promoting accountability within the community.

5. A client with chronic congestive heart failure should be instructed to contact the home health nurse if which finding occurs?

• A. Weight gain of 2 pounds or more in a 48-hour period
• B. Urinating 4 to 5 times a day
• C. A significant decrease in appetite
• D. Appearance of non-pitting ankle edema

Correct answer: A

Rationale: A rapid weight gain of 2 pounds or more in a 48-hour period may indicate fluid retention and worsening heart failure, requiring prompt medical evaluation and intervention. This finding is crucial in managing chronic congestive heart failure as it signifies a potential exacerbation of the condition. Choices B, C, and D are less concerning in this context. Urinating 4 to 5 times a day is within the normal range for most individuals and may not be directly related to heart failure. A significant decrease in appetite may be due to various factors and might not be an immediate cause for concern in heart failure patients. The appearance of non-pitting ankle edema, although related to heart failure, is a more chronic and less urgent symptom when compared to a rapid weight gain, which requires immediate attention.

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