The older adult client wishes to be discharged home after a kyphoplasty. The client has a history of emphysema requiring oxygen at home. To ensure discharge to home is appropriate, which is most important for the nurse to assess?

The nurse manager is mediating a grievance brought by the NA about the nurse after the NA was unsuccessful in resolving the conflict. At the mediation session the NA repeatedly states that THE nurse’s delegation is unfair and overloading while the nurse continues to repeat the REASONS for the delegated activities. Which is the nurse manager’s best course of action at this time?

Several nurses are discussing their unhappiness with some residents of an extended care facility placing increased demands on staff. Which statement, if made by one of the nurses, suggests a unit culture characteristic of transformational leadership?

The day charge nurse is preparing to report to the oncoming shift nurse. Which action should be taken first by the charge nurse when learning that the unit will be short-staffed because two nurses called in ill and the hospital does not have any extra nurses?

The nurse educator is responsible for teaching staff members about a change in a central line dressing change procedure. Which method of education would best enhance the staff’s retention of this information?

The nurse manager is planning an orientation program for new graduates. Which strategies should the nurse manager consider to promote retention of these nurses?

The nurse reviews the admission findings after treating the client who had fallen and determines that a fall assessment was not completed on admission. Which is the best action by the nurse?

Two days after the client’s admission, the nurse notices an omitted order to implement a venous thromboembolic protocol. Which statement best describes appropriate initial follow-up?

In reviewing an HCP’s orders for the client, the oncoming shift nurse finds that an antibiotic was pre- scribed but is not listed on the client’s MAR. Three doses were missed. Which action should minimize the nurse’s malpractice risk?

The family complains to the oncoming shift nurse about the poor care provided by the previous nurse. They state that discharge instructions including how to perform dressing changes and the client’s activity level were confusing and incorrect. After meeting the client and family needs, which action should the oncoming nurse take to prevent this situation from happening again?

Prior to medication administration, a hospital policy requires a double-check of two unique client identifiers against the MAR. The nurse manager forms a performance improvement team with the goal of improving nursing compliance with this important safety check. Which activity, related to checking two unique identifiers, should be the responsibility of the performance-improvement team?

The nurse manager is teaching nursing staff about the use of an evidence-based practice (EBP) framework for performance improvement. Which description should the nurse manager include?

The client is scheduled to have a CXR and a pulmonary function test (PFT). The client tires easily. Which action should be taken by the nurse to best coordinate the client’s care?

The nurse is aware of the American Nurses Association’s nursing-sensitive quality indicators regarding the management and prevention of hospital- acquired infections. Which nursing action is most likely to reduce hospital-acquired infection rates?

The homeless client is being discharged from the hospital. The client has no family support or resources. To which service should the nurse refer the client?

The client is admitted for coronary artery bypass surgery (CABG) with an anticipated admission to the coronary care unit (CCU). In preparation for the client’s hospital admission, implementation of which component will best predict the sequence and timing of care, and direct the course of the client’s hospital stay?

The client is hospitalized for GI bleeding. The client’s family tells the nurse the client has a history of drinking four to eight beers every day. The client lives alone, is unemployed, and is uninsured. Which collaborative action provides the best overall client care?

The HCP notifies the nurse that the client will be discharged from the hospital tomorrow. The client is unable to ambulate to the bathroom independently, lives alone, and has a poor appetite. With which discipline is it most important for the nurse to collaborate for discharge planning?

The elderly client, who has been newly diagnosed with end-stage COPD, is to be discharged home. The client is unable to provide self—care and requires continuous assistance. Which service would provide the greatest assistance to the client’s spouse, who would be the sole caregiver?

The client is going home with a new prescription of fluticasone/salmetcrol diskus. The client has never used a diskus delivery system before. Which member of the health care team should the nurse consult to instruct the client in the proper use of the diskus?

The client with CRF is placed on a restricted renal diet that includes limiting protein and dairy intake. Alter reviewing a list of allowed, limited, and restricted foods, the client tells the muse, “I don’t like any of the acceptable food choices, and some are against my faith beliefs!” Which collaborative action would best meet the client’s needs?

The nurse assesses that the client with delirium tremens is becoming increasingly agitated. The nurse notes that IV doses of diazepam, Iorazepam, and propofol are prescribed for the client, but is unclear regarding which medication would be most effective. Which action by the nurse will best improve the client’s outcome?

The nurse finds the client in respiratory distress with a decreasing level of consciousness and calls the ART. The ICU nurse is on the ART. Which action demonstrates that the ICU nurse is a resource to the nurse on the medical unit?

The client is being transferred to a subacute unit at another facility. The nurse calls the facility to give a verbal report to the nurse assuming the client’s care. Which statement best ensures that the continuity of care is maintained?

The nurse notices a posting on a bulletin board for a continuing education (CE) offering on the prevention of pressure ulcers. Which is the most compelling reason for the nurse to attend?

At a staff meeting, the nurse manager shares that the unit is over budget by 2% and needs to reduce costs. A staff nurse suggests that reports could be shortened so that nurses could finish their shifts on time. How should the nurse manager measure the success of this idea once implemented?

TWO years ago, the older adult client was diagnosed with CRF requiring dialysis. The client is admit- ted to a hospital with pneumonia for the third time in the last 9 months. Which health care team member should the nurse consult to enable the client to cope with a chronic disease?

The nurse manager is evaluating the new nurse’s time-management skills. Which statement made by the new nurse may indicate potential concerns with time management?

The new nurse manager on the maternity unit is informed by staff that family members have been unhappy about the policy limiting the number of visitors for the first 24 hours postpartum. Which initial action by the nurse manager is most appropriate?

The client with hyperglycemia is receiving a continuous IV insulin drip. The nurse checking the client’s blood glucose hourly obtains a reading of 32 mg/dL. The client who was alert is now lethargic and does not respond to questions. The nurse administers 25 mL of Dsow per protocol. The client begins to respond. Which additional risk-management action should be taken by the nurse?

The 72-year—old client with a left leg DVT and a history of a brain tumor is hospitalized for 3 days. The client’s care plan indicates a nursing problem of Imbalanced nutrition: less than body requirements related to poor appetite and decreased oral intake. Which assessment finding would best indicate a need to revise the care plan related to the nursing problem?

The new nurse reattaches the client’s pulse oximeter finger probe afier it was off and the machine was alarming. When the alarm is heard again, the nurse finds a reading of 84 with the number quickly changing to 92. The client’s pulse oximeter readings continue to vary from 84 to 94, causing the machine to alarm frequently. Which action will help the nurse to establish a safe and accurate pulse oximeter reading?

The nurse reviews the plan of care for the client with COPD and limited mobility. The nurse notes that the physical therapist changed the plan to progress the client’s ambulation from 100 to 200 feet twice a day. Which intervention should the nurse implement to ensure that the client’s needs are met?