A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?

Correct Answer: A

Rationale: The correct answer is A: Wear an N95 respirator when giving direct care to the client. This is correct because allogeneic stem cell transplant recipients are at high risk for infection due to immunosuppression. An N95 respirator helps protect the nurse from inhaling airborne pathogens when in close contact with the client. Choice B is incorrect because negative-pressure airflow rooms are typically used for clients with airborne infections, not for those at risk due to immunosuppression. Choice C is incorrect because although adequate air exchanges are important for infection control, it is not the specific precaution needed for a client with an allogeneic stem cell transplant. Choice D is incorrect because wearing a mask outside the room is not as effective in preventing transmission of infections as wearing an N95 respirator during direct care.

Correct Answer: B

Rationale: The correct answer is B because the assigned staff healthcare provider is not an essential component in developing a critical pathway for congestive heart failure (CHF). The rationale is that the focus of a critical pathway is on standardizing the care process to improve outcomes and efficiency. Including specific assigned staff members may not be feasible due to staffing variations and may limit flexibility in care delivery. Expected length of stay (A) helps in planning resources, patient outcomes (C) are crucial for evaluating effectiveness, and medical diagnosis (D) guides treatment protocols. Therefore, choice B is not essential compared to the other components.

Correct Answer: C

Rationale: The correct answer is C because the client's statement demonstrates a desire for comfort-focused care, which is the essence of palliative care for terminal cancer patients. The client is expressing a clear preference for measures that prioritize comfort and quality of life over aggressive treatment. This indicates readiness to receive information about palliative care. Choice A is incorrect because the client mentions chemotherapy for a cure, indicating a focus on curative treatment rather than comfort care. Choice B is incorrect as the client seems to be expressing a desire for a quick end to their suffering, which may not align with palliative care goals. Choice D is incorrect because the client is expressing unrealistic optimism about recovery, which may hinder acceptance of palliative care.

Correct Answer: D

Rationale: The correct answer is D: Two days. The Uniform Standards of Professional Appraisal Practice (USPAP) requires a minimum of two days' notice for an appraisal. This time frame allows the appraiser to adequately prepare for the appraisal assignment, gather necessary information, and schedule the inspection. Choice A is incorrect as one day is not sufficient time for proper preparation. Choice B is incorrect as no notice is not in compliance with USPAP standards. Choice C is incorrect as one week exceeds the minimum requirement of two days.

Correct Answer: C

Rationale: The correct answer is C: Collaborative decision making. This is a common characteristic of a high-performing healthcare team because it promotes teamwork, respect for diverse perspectives, and ensures that decisions are made collectively with input from all team members. Collaborative decision making allows for better problem-solving, increases team morale, and fosters a sense of ownership and accountability among team members. A: Effective communication is important in a healthcare team, but it alone does not guarantee high performance. B: Shared leadership is valuable, but it is not as essential as collaborative decision making in ensuring team success. D: Hierarchical structure can hinder collaboration and innovation within a team, making it less likely to be high-performing. In summary, collaborative decision making is the best choice as it promotes teamwork, inclusivity, and better decision outcomes within a healthcare team.

Correct Answer: C

Rationale: The correct answer is C: Maintain a consistent time to wake up each day. This recommendation helps regulate the body's internal clock, promoting a consistent sleep-wake cycle. By waking up at the same time every day, the client's body will naturally adjust and improve their ability to fall asleep at night. Watching TV in bed (A) can disrupt sleep due to the blue light emitted. Drinking hot cocoa (B) may not be ideal close to bedtime due to the caffeine content. Exercising before bed (D) can stimulate the body and make it harder to fall asleep.

Correct Answer: C

Rationale: The correct answer is C because stating "I can choose any foods, as long as I use enough insulin to cover the calories" shows a lack of understanding of diabetes management. In type 1 diabetes, it's crucial to follow a balanced diet to regulate blood sugar levels. Choosing any foods without considering their impact on blood sugar control can lead to unstable glucose levels. Explanation for why the other choices are incorrect: A: Choosing to have an occasional alcoholic drink if included in the meal plan is acceptable as long as it's done in moderation and accounted for in the overall diabetes management plan. B: Needing a bedtime snack with NPH insulin is appropriate to prevent hypoglycemia overnight. D: Eating something at meal times to prevent hypoglycemia, even if not hungry, is a good practice to maintain stable blood sugar levels.

Correct Answer: D

Rationale: The correct answer is D because in a functional structure, tasks are grouped by function. All nursing tasks falling under nursing service exemplifies this as it centralizes nursing responsibilities within the nursing department. A is incorrect as it describes communication, not structure. B is incorrect as it implies a hierarchy, not a functional structure. C is incorrect as it suggests a lack of authority, not the grouping of tasks.

Correct Answer: D

Rationale: The correct answer is D: Job satisfaction. Job satisfaction is crucial in sustaining employee satisfaction as it directly impacts how content and fulfilled employees feel in their roles. When employees are satisfied with their jobs, they are more likely to be engaged, motivated, and productive. This leads to higher retention rates and overall better performance. On the other hand, organization culture (A) is important but not the sole factor in sustaining employee satisfaction. Individual performance (B) and performance evaluation (C) are more related to assessing employee output rather than directly impacting their satisfaction levels.