A nurse manager is receiving report and is faced with the following situations that require interventions. Which of the following should the nurse manager address first?
A client is refusing care from an assistive personnel of the opposite gender
No transport assistance is available to take a client to physical therapy
Two nurses had a heated disagreement about a scheduling issue
Three staff members have called to say they will be absent
The Correct Answer is D
a. A client is refusing care from assistive personnel of the opposite gender:
This situation involves the client's right to refuse care based on personal preferences or cultural beliefs. While it requires attention and respect for the client's wishes, it may not pose an immediate risk to patient care or staff safety.
b. No transport assistance is available to take a client to physical therapy:
This can be resolved by contacting the transportation department or finding an alternative solution, but it is not a critical issue that requires immediate attention.
c. Two nurses had a heated disagreement about a scheduling issue:
While workplace conflicts should be addressed to promote a positive work environment, a heated disagreement about a scheduling issue may not pose an immediate threat to patient care. However, if the disagreement escalates or affects staff morale, it could impact unit functioning and require intervention.
d. Three staff members have called to say they will be absent:
This situation has the most immediate impact on the overall functioning of the unit. Staffing shortages can affect patient care and safety, so it is crucial to address this issue promptly to ensure adequate coverage and maintain the quality of care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a. Decreased level of consciousness:
This finding is concerning and may indicate worsening neurological status, increased intracranial pressure, or impending herniation. A decreased level of consciousness requires immediate evaluation by the provider to assess for neurological deterioration and potential interventions to stabilize the client's condition.
b. Increased temperature:
While an increased temperature (fever) is commonly associated with meningitis due to the inflammatory response, it may not necessarily require immediate reporting unless it is extremely high or accompanied by other concerning symptoms. Fever management is important, but it may not warrant immediate provider notification unless it is severe or refractory to treatment.
c. Generalized rash over trunk:
A generalized rash can be associated with certain types of meningitis, such as meningococcal meningitis, and may indicate sepsis or disseminated infection. However, it may not always require immediate provider notification unless it is accompanied by other concerning symptoms or signs of systemic illness.
d. Report of photophobia:
Photophobia (sensitivity to light) is a common symptom of meningitis and is often reported by clients. While photophobia is significant in the context of meningitis, it may not require immediate provider notification unless it is severe or accompanied by other worrisome neurological symptoms.
Correct Answer is D
Explanation
a. "I will ask your mother's primary care provider to speak with you."This response does not address the issue of confidentiality and consent. The nurse should not assume that the provider will discuss the treatment without the client's consent.
B.“You will have to speak directly to your mother about her treatment.”This response correctly redirects the child to the client but does not fully explain the importance of consent and confidentiality, which are crucial in maintaining professional and ethical standards.
C.“What would you like to know about your mother’s treatment.”This response might imply a willingness to share information without the client’s consent, which would be a violation of confidentiality and privacy laws.
D.“I cannot provide this information to you without your mother’s consent.”Correct. This response clearly states the need for the client’s consent before any information can be shared, adhering to the principles of confidentiality and the Health Insurance Portability and Accountability Act (HIPAA) regulations.
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