Choice A rationale: While Magnet status can enhance a hospital's reputation and attract patients, the primary purpose of seeking Magnet status is to acknowledge and validate the quality of nursing care, rather than primarily serving as a marketing tool.

Choice B rationale: While Magnet status may contribute to attracting highly qualified nursing staff, the primary focus is on recognizing and promoting excellence in patient care, not specifically on the recruitment of nurses with a particular educational background.

Choice C rationale: Magnet status is not primarily focused on the breadth of services a facility provides. Instead, it is centered on the quality and excellence of nursing care.

The designation does not necessarily indicate the quantity or variety of services offered by a healthcare facility.

Choice D rationale: Magnet status is a designation granted by the American Nurses Credentialing Center (ANCC) to healthcare organizations that demonstrate excellence in nursing practice and outstanding patient care. It signifies that the facility has met rigorous standards for nursing quality, professionalism, and overall commitment to delivering exceptional care to patients.

Choice A rationale: Assigning the orientee to work with an experienced nurse who is a long-time, efficient employee can help the orientee improve her skills and confidence.

Choice B rationale: Waiting until the end of the second week may lead to further issues and does not actively address the current challenges the orientee is facing.

Choice C rationale: Informing the supervisor without directly addressing the nurse may not be the most supportive or proactive approach.

Choice D rationale: Talking to the orientee about working in a less stressful environment may not be the most proactive step at this point. Providing support and guidance within the current work environment is a more immediate solution.

Choice A rationale: The assessment is the client's signed power of attorney and a home medication list, which are important documents that indicate the client's wishes and potential drug interactions. While the client's healthcare power of attorney is important information, the reason for admission should be provided first to give context to the situation.

Choice B rationale: The nurse should start by presenting the immediate situation or concern, which is the client's increasing confusion which needs immediate attention. Choice C rationale: The recommendation is the nurse's suggestion for further diagnostic tests, interventions, or referrals based on the situation, background, and assessment. The currently prescribed medications are relevant, but the primary reason for admission should be communicated first to establish the context of the client's condition. Choice D rationale: The background is the fall at home as the reason for admission, which explains the possible cause of the confusion and the loss of consciousness. This comes after the situation which is the increasing confusion.

Choice A rationale: Reminding the client about new treatments does not address the refusal to write do-not-resuscitate instructions and may not be the most appropriate action.

Choice B rationale: While facilitating a palliative care meeting is important for addressing end-of-life care, it doesn't directly address the provider's refusal to write do not-resuscitate instructions.

Choice C rationale: Providing the healthcare provider with a copy of the client's bill of rights may not be the most effective action in this situation.

Choice D rationale: Initiating a review of the situation by the hospital's ethics committee is appropriate when there is a disagreement between the client's wishes and the healthcare provider's refusal. The ethics committee can help navigate and resolve ethical concerns.

Choice A rationale: The client post triple coronary bypass with serosanguinous drainage in one chest tube requires attention but is not the highest priority based on the information provided.

Choice B rationale: The client with diabetic ketoacidosis and a blood glucose level of 195 mg/dl (10.8 mmol/L) needs immediate attention due to the elevated glucose level but the client with a pneumothorax and low oxygen saturation takes precedence.

Choice C rationale: The client with an Ileal conduit and scant blood in the drainage pouch is a concern but not as urgent as the client with diabetic ketoacidosis.

Choice D rationale: The client with a pneumothorax has a life-threatening condition that requires immediate attention. A pulse oximeter reading of 90% indicates hypoxia, which can lead to organ damage and death.

Choice A rationale: The initial administration of the opioid analgesic is appropriate as long as the nurse adheres to the prescription made.

Choice B rationale: Administering naloxone via IV is an appropriate intervention to reverse the effects of opioid toxicity. It is not the focus of counseling in this scenario.

Choice C rationale: The nurse should have notified the healthcare provider as soon as the client's respiratory rate decreased to 6 breaths/minute, which is a sign of respiratory depression caused by the opioid analgesic. The nurse should not have waited until the client's respiratory rate decreased to 4 breaths/minute, which is a life-threatening condition that requires immediate intervention.

Choice D rationale: Documentation of the client's respiratory rate is essential for monitoring, and there is no indication that the documentation was inappropriate.

Choice A rationale: Vital signs within the normal range two hours after receiving morphine do not indicate an immediate need for intervention by a registered nurse. Choice B rationale: A client reporting severe pain one hour after receiving hydromorphone requires assessment and intervention by a registered nurse to determine the cause of the pain and implement appropriate measures. Hydromorphone is a potent opioid analgesic that can cause serious side effects such as respiratory depression, sedation, hypotension, and constipation. A registered nurse has the knowledge and skills to monitor these effects and intervene if necessary.

Choice C rationale: Changing a fentanyl transdermal patch is a routine procedure and can be safely performed by a practical nurse.

Choice D rationale: A postoperative client reporting incisional pain requires assessment, but the pain level alone does not indica

Choice A rationale: Recording the client's pulse volume distal to the IV site is a nursing responsibility as it involves an assessment of circulation.

Choice B rationale: Reapplying cold compresses is a task that UAP can perform to help minimize swelling and discomfort at the extravasation site.

Choice C rationale: Disposing of the IV tubing after the infusion is discontinued is a nursing responsibility to ensure proper disposal and prevent contamination.

Choice D rationale: Teaching the client about the need to keep the extremity elevated involves patient education and is within the scope of nursing practice.

- Choice A Rationale: This choice is not optimal because the PN has the skills necessary to assist with the thoracentesis, a procedure that requires clinical judgment and skill, which the UAP does not possess. The RN is also needed to obtain the report from the ED due to the complexity of unstable angina, which requires advanced knowledge and assessment skills.

- Choice B Rationale: This option incorrectly assigns the UAP to prepare the room, which is within their scope, but fails to utilize the PN's skills effectively. The PN should be involved in more complex tasks such as assisting with procedures or obtaining detailed reports, rather than the UAP.

- Choice C Rationale: This choice is inappropriate because it assigns the UAP to assist with the thoracentesis, a task they are not trained for and is outside their scope of practice. The RN should be involved in the more complex care of obtaining the report, and the PN should assist with the thoracentesis.

- Choice D Rationale: This is the correct choice because it utilizes all staff members according to their scope of practice and skills. The PN assists with the thoracentesis, a task they are qualified for, the RN obtains the report on the new admission, which requires advanced knowledge, and the UAP prepares the room, a task that fits their role.

- Choice E Rationale: As there is no Choice E provided in the question, no rationale can be given for this option. It is important to follow the instructions and options given in the scenario to provide accurate and relevant information.

Choice A rationale: Paging a chaplain on call can be a supportive measure, but it might not address the immediate need for communication and coordination with the family.

Choice B rationale: Allowing each family member to ask a question one at a time may not be the most effective approach when dealing with multiple and repetitive questions.

Choice C rationale: Requesting the healthcare provider to speak with the family might be appropriate, but it could take time, and the immediate need is to establish effective communication.

Choice D rationale: Asking the family to identify a specific spokesperson helps streamline communication and ensures that information is conveyed more efficiently. This approach can help manage the situation and address the family's concerns collectively.