An experienced, female practical nurse (PN) is hired to work on the surgical unit of a tertiary hospital. The first day she is working on the unit, the PN tells the charge nurse that she has excellent wound care skills. It is a busy day and a postoperative client needs to have a sterile dressing change. Which action is best for the charge nurse to take?
Review the PN's skill checklist to assess for wound care competency.
Watch the PN perform sterile wound care to validate her skill level.
Tell the PN that past experience does not indicate ability to perform skills.
Ask the PN to change the sterile dressing while the nurse is busy.
The Correct Answer is B
A) This action is not the best because it does not directly evaluate the PN's wound care skills in practice. A skill checklist may not reflect the current or actual abilities of the PN, especially if it is outdated or based on self-
reporting. The charge nurse should observe the PN's performance in person to ensure that she follows the proper procedures and protocols for sterile wound care.
B) This action is the best because it allows the charge nurse to verify the PN's wound care skills and provide feedback or guidance if needed. The charge nurse has a responsibility to ensure that the PN delivers safe and effective care to the clients on the unit. By watching the PN perform sterile wound care, the charge nurse can assess her competence, confidence, and compliance with standards of practice.
C) This action is not the best because it is disrespectful and discouraging to the PN. The charge nurse should not dismiss or undermine the PN's past experience, which may have contributed to her wound care skills. The charge nurse should acknowledge and appreciate the PN's expertise, but also verify her skill level through direct
observation.
D) This action is not the best because it exposes the client to potential harm and liability. The charge nurse should not delegate a task that requires assessment and evaluation to a PN without first confirming her skill level and competency. The charge nurse should also not ask the PN to perform a task while she is busy with other duties, as this may compromise the quality and safety of care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason: Choosing to send another nurse who is more receptive is not a good option, as it may create
resentment and conflict among the staff. The older nurse may feel discriminated against or excluded, and the other nurse may feel burdened or pressured. The nurse manager should try to engage and motivate the older nurse to attend the in-service session, as it is important for her professional development and patient safety.
Choice B Reason: Asking the nurse why she thinks there is no need for an in-service program about these emergencies may sound confrontational or accusatory and may put the nurse on the defensive. The nurse manager should avoid making assumptions or judgments about the nurse's attitude or beliefs, and instead try to understand her perspective and address any barriers or misconceptions.
Choice C Reason: Informing the older nurse that inservice is not optional and her scheduled attendance is mandatory may be true, but it may also sound authoritarian or coercive, and may undermine the nurse's autonomy or dignity. The nurse-manager should avoid using threats or ultimatums, and instead try to explain the rationale and benefits of the inservice session, and solicit the nurse's input or feedback.
Choice D Reason: Encouraging the nurse to share her concerns and discuss ways to prepare for such emergencies is the best option, as it shows respect and empathy for the nurse, and fosters a collaborative and supportive
relationship. The nurse-manager should use active listening and open-ended questions, and provide relevant information and resources to help the nurse overcome her fears or doubts, and enhance her confidence and competence.
Correct Answer is C
Explanation
Choice A Reason: This client may need another dose of hydromorphone if the pain is not relieved by the previous one. A PN can administer this medication under the supervision of a RN and monitor the client's response.
Choice B Reason: This client's vital signs are within normal limits and indicate that the morphine is effective and not causing respiratory depression. A PN can assess and document the client's vital signs and pain level.
Choice C Reason: This is the correct answer because this client has acute and severe pain that may require immediate intervention and reassessment. An RN can evaluate the cause and severity of the pain, administer additional analgesics as prescribed, and implement nonpharmacological measures to relieve the pain.
Choice D Reason: This client has chronic and stable pain that is managed by a fentanyl patch. A PN can replace the patch according to the schedule and instructions provided by the RN.
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