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 A skill checklist may not reflect the current or actual abilities of the PN, especially if it is outdated or based on self-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: Confronting the nurse manager as a group may not be effective or appropriate, as it may create more conflict and resentment. The charge nurse should follow the chain of command and escalate the issue to a higher authority if the nurse manager fails to act.
Choice B reason: Attending procedures performed by the surgeon and demanding halting of the procedure if the client becomes distressed may be seen as insubordination and interference by the surgeon, who may have legal authority to perform the procedure. It may also jeopardize the client's safety and outcome.
Choice C reason: Documenting client reactions to invasive procedures performed by the physician in their medical record is important, but not sufficient. It does not address the root cause of the problem, which is the surgeon's lack of empathy and respect for clients' pain and dignity.
Choice D reason: Reporting the physician's lack of concern for clients' pain during invasive procedures to the Director of Nursing is the most important action for the charge nurse to take, as it may lead to an investigation and corrective measures. The Director of Nursing has more power and responsibility than the nurse manager to deal with such issues and protect clients' rights and welfare.
Correct Answer is D
Explanation
Choice A Reason: This is not the first priority because it does not address the client's immediate needs. The nurse should obtain the client's legal records for power of attorney, but this can be done later.
Choice B Reason: This is a good action because it helps relieve the client's pain and discomfort. The nurse should give analgesic medications as needed (PRN), but this is not enough to meet the client's holistic needs.
Choice C Reason: This is not an appropriate action because it may cause harm to the client. The nurse should not discontinue the intravenous infusion without a valid reason and a healthcare provider's order.
Choice D Reason: This is the best action because it respects the client's wishes and provides him with quality end-of-life care. The nurse should ask the palliative care team to speak with the client and offer him emotional, spiritual, and physical support.
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