A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically Impaired. What is the manager's most appropriate action?

Promptly confront the nurse to discuss this suspicion

Ask the other nurses and staff members on the unit if they have noticed the same thing

Document this finding and communicate with the personnel department

Monitor the nurse's behavior closely for the remainder of the shift

Answer and Explanation

The Correct Answer is D

A.   While it is important to address concerns about impairment, confronting the nurse directly can be counterproductive and may escalate the situation. It is essential to approach the situation with caution and follow established protocols for dealing with suspected substance impairment.
B.   While gathering observations from colleagues may seem reasonable, it can create a culture of gossip and may violate confidentiality. This approach can also lead to misinformation and should not be the first step in addressing a serious concern about a colleague's safety and well-being.
C.   Documenting observations is important, but it should not be the sole action taken at this point. Communicating with the personnel department is part of the process if the situation escalates, but immediate action is necessary to ensure patient safety.
D.   This option is the most appropriate initial action. By closely monitoring the nurse’s behavior, the manager can gather more information before taking further steps. This approach allows for the collection of objective data and ensures patient safety while avoiding premature accusations.

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Correct Answer is B

Explanation

A. Monitoring temperature is also important, but it does not directly prevent a crisis.
B. Hydration is critical for children with sickle cell anemia, as it helps prevent sickle cell crises by promoting adequate blood flow and reducing blood viscosity. Encouraging frequent fluid intake is essential in managing the condition.
C. While it's important to monitor activity levels, outright restriction may not be necessary. Instead, children with sickle cell anemia should be encouraged to engage in age-appropriate activities while avoiding extreme temperatures and strenuous activities that could trigger a crisis. Balanced activity is essential for overall health and development.
D. Cold compresses are not typically recommended for managing pain during a sickle cell crisis. Instead, warmth is often preferred because it helps to relax muscles and improve blood flow. Cold can potentially exacerbate vasoconstriction, which is not beneficial for a child experiencing pain due to sickle cell disease.

A. ask each LPN what tasks he or she is comfortable performing. B. delegate the same tasks to the LPNs that the RN normally delegated to NAPS. C. consult a decision tree for delegation to unlicensed assistive personnel. D. review the practical nurse scope of practice in the jurisdiction where they are working.

Correct Answer is D

Explanation

A. While it’s important to consider the comfort and competency of the LPNs, this approach alone does not ensure that the tasks delegated are within their legal scope of practice. It’s essential for the RN to also verify that the tasks align with the LPN’s training and legal scope of practice.
B. LPNs have a different scope of practice compared to nursing assistive personnel (NAP). They are trained to perform more complex tasks and provide a higher level of care than NAPs. Delegating the same tasks would not take advantage of the LPN's training and could lead to issues related to patient safety and quality of care.
C. While consulting a decision tree can be a useful tool for delegating tasks to NAPs, it does not apply to LPNs. LPNs have a different scope of practice and require a different framework for delegation, as they can perform nursing tasks that are not within the NAP scope.
D. This is the most appropriate action for the RN. Understanding the legal scope of practice for LPNs in their specific jurisdiction is crucial for safe and effective delegation. It ensures that the RN delegates tasks that LPNs are qualified to perform, thereby promoting patient safety and adhering to legal standards.

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A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically Impaired. What is the manager's most appropriate action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

A registered nurse has been leading teams of nursing assistive personnel (NAP) for several years and will soon be leading licensed practical nurses (LPNs) for the first time. In preparation for delegating to these nurses, the RN should:

Correct Answer is D

Explanation

What consideration should the nurse-manager prioritize when creating a program to deal with the issue of substance abuse by employees?

A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically Impaired. What is the manager's most appropriate action?

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A nurse is admitting a client who has sickle cell anemia. Which of the following manifestations should the nurse expect with this condition?(Select All that Apply.)