A nurse manager has asked other nurses to contribute to the performance appraisal of a newly licensed nurse.

Exhibits

For each assessment finding, click to specify if the finding is consistent with the need for further nurse development related to Time Management, Delegation, or Professional Behavior. Each finding may support more than 1 assessment finding.

Frequent trips to supply room when doing bedside care such as wound care.

Notes on clients written on multiple small pieces of paper.

Does not take breaks.

Coming early and staying late to chart.

Frequent personal phone calls during shift.

Covering other nurses' clients for breaks.

Missed prescriptions in the EHR.

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A,C"},"D":{"answers":"A"},"E":{"answers":"C"},"F":{"answers":"B"},"G":{"answers":"A,C"}}

Time Management: Concerns related to how the nurse manages their time, including the efficiency of their work and how they handle their responsibilities (e.g., frequent trips to the supply room, notes written on small pieces of paper, coming early and staying late to chart).

Delegation: Issues related to the nurse's ability to delegate tasks effectively (e.g., covering other nurses' clients for breaks, which could suggest issues with delegation).

Professional Behavior: Concerns related to the nurse's conduct and adherence to professional standards (e.g., frequent personal phone calls during shifts, not taking breaks, missed prescriptions, covering other nurses' clients without taking breaks).

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Correct Answer is A

Explanation

Rationale:

A. Withholding a dose of narcotic pain medication when there is respiratory depression aligns with nonmaleficence, as it prevents further harm by not exacerbating the client's respiratory issues.

B. Discussing advance directives is important but is more related to autonomy and respect for the client’s wishes rather than nonmaleficence.

C. Providing comfort care is a supportive measure but does not specifically address nonmaleficence in terms of preventing harm.

D. Allowing unlimited visitation respects family wishes but does not directly relate to the principle of nonmaleficence regarding the client’s immediate medical needs.

A. A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6 B. A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous C. A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL D. A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg

Correct Answer is D

Explanation

Rationale:

A. A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6 needs pain management, but this is less urgent compared to potential signs of hypotension.

B. A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous indicates normal progression of wound healing; thus, it is less critical.

C. A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL needs blood glucose management, but this is less urgent than assessing for potential hypovolemia or shock.

D. A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg is experiencing a significant drop in blood pressure, which could indicate hypovolemia or shock. This requires immediate assessment and intervention to prevent complications.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is dying. The nurse should incorporate the principle of nonmaleficence into practice by taking which of the following actions?

Correct Answer is A

Explanation

A nurse is caring for four clients who are postoperative from surgery 24 hr ago. At 1200 the nurse assesses the clients. Which of the following clients is the nurse's priority?

Correct Answer is D

Explanation

An RN is delegating care activities to a licensed practical nurse (LPN). Which of the following is the priority criterion the RN should consider when delegating?

A nurse is preparing to administer a soap suds enema to a client who has constipation. As the nurse explains the procedure, the client states, "The doctor didn't tell me I was supposed to receive an enema." Which of the following nursing actions is appropriate at this time?

A charge nurse plans to use effective change strategies when implementing a change in a nursing procedure on the medical-surgical unit. Which of the following actions should the charge nurse take during the moving stage of change?

A charge nurse has assigned a group of clients to a licensed practical nurse (LPN). The charge nurse receives reports from her assigned clients about the LPN's lack of care. Which of the following actions should the charge nurse take?

A nurse is caring for four postoperative clients. The nurse can delegate obtaining vital signs to an assistive personnel (AP) for which of the following clients?

A nurse is providing discharge teaching for a client who has a new prescription for home oxygen. Which of the following instructions should the nurse include in the teaching?

A charge nurse is working with an assistive personnel (AP) who provides excellent care to clients and is an effective team member. Which of the following actions should the nurse take first to recognize the AP's contributions to client care?

A nurse manager received a client request not to have a specific staff nurse care for her while at the acute care facility. Which of the following is the appropriate action by the nurse manager?