A nurse who was recently certified in chemotherapy administration fails to check compatibility of phenytoin (Dilantin) before injecting into a continuous infusion of D W leading to occlusion of the line. Which statement by the nurse demonstrates a red herring?

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Question 1 of 5

A nurse who was recently certified in chemotherapy administration fails to check compatibility of phenytoin (Dilantin) before injecting into a continuous infusion of D W leading to occlusion of the line. Which statement by the nurse demonstrates a red herring?

Correct Answer: D

Rationale: The correct answer is D because it is a red herring statement that distracts from the main issue. Phenytoin is not known to be viscous enough to cause line occlusion. Step 1: Identify the issue - failure to check compatibility. Step 2: A, B, and C address the issue directly or indirectly, while D deflects blame to the drug's viscosity. Step 3: A acknowledges the mistake, B deflects by attacking the supervisor, and C blames the IV setup. In summary, D is incorrect as it diverts attention from the main issue, making it a red herring.

Question 2 of 5

A nurse is asked to "float" to another area where the patients require total care. The nurse smiles, picks up her stethoscope, and says, "I'll come back and eat lunch with everyone here." When she enters the elevator she hits the wall and mutters, "Always me. Don't I have any rights"? The nurse is demonstrating which communication style?

Correct Answer: D

Rationale: The correct answer is D, passive-aggressive. The nurse is indirectly expressing her displeasure and resistance to floating by smiling and agreeing to come back for lunch, but then displaying negative body language and muttering under her breath. This behavior is passive on the surface but aggressive in the underlying tone. The nurse is not openly confronting the issue but is still showing resistance and frustration. A: Assertive communication involves expressing one's needs and feelings in a direct and respectful manner. The nurse is not openly communicating her feelings or needs in this scenario. B: Aggressive communication involves expressing needs and feelings in a forceful and hostile manner. The nurse's behavior is not openly hostile towards others. C: Passive communication involves avoiding conflict and not expressing one's needs or feelings. The nurse is indirectly expressing her displeasure, so it's not purely passive.

Question 3 of 5

A patient is admitted with hypotension, shortness of breath, flushing, and hives. All levels of staff have been trained to assess vital signs. Given budget restrictions and proper delegation rules, to which care provider would the RN delegate the task of obtaining the initial blood pressure reading?

Correct Answer: C

Rationale: The correct answer is C. The Unlicensed Assistive Personnel (UAP) can be delegated the task of obtaining the initial blood pressure reading because this task is within their scope of practice and does not require specialized nursing knowledge or assessment skills. The UAP can be trained and supervised to accurately measure blood pressure, freeing up the RN to focus on assessing the patient's overall condition and providing necessary interventions. Delegating this task to the UAP is cost-effective and efficient, allowing the RN to prioritize critical nursing assessments and interventions for the patient's presenting symptoms. Incorrect choices: A: RN - The RN should not perform tasks that can be safely delegated to other members of the healthcare team to optimize efficiency and resource utilization. B: LPN/LVN - While LPNs/LVNs have more advanced training than UAPs, obtaining a blood pressure reading is a basic task that can be appropriately delegated to UAPs. D: Using the blood pressure obtained in the ambulance - This option does

Question 4 of 5

An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision?

Correct Answer: C

Rationale: The correct answer is C: Continual supervision is being provided until the RN determines competency. Rationale: 1. Continual supervision is necessary for the LPN/LVN on the first day to assess their competency. 2. The RN checks frequently throughout the shift to provide support and evaluate the LPN/LVN's performance. 3. Competency must be determined before reducing supervision levels. 4. This level of supervision ensures patient safety and quality care. Incorrect choices: A: There is no supervision - Incorrect because supervision is provided by the RN. B: Periodic inspection - Incorrect as continual supervision is needed for competency assessment. D: Initial supervision - Incorrect as supervision should continue until competency is established. In summary, choice C is correct as continual supervision is crucial for the LPN/LVN on their first day to ensure patient safety and quality care.

Question 5 of 5

A nurse moves from California to Arkansas and due to having 20 years of experience as a registered nurse is immediately placed in charge of the telemetry unit. The staffing consists of LPNs and two unlicensed assistive personnel. The RN is unsure of the scope of practice of the LPNs and reviews the nurse practice act for Arkansas, which lacks clarity on some tasks. The RN should:

Correct Answer: C

Rationale: The correct answer is C: contact the state board of nursing to determine legal scope of practice for LPNs. This is the most appropriate action because the state board of nursing is the authoritative body that governs nursing practice within a specific state. By contacting the board, the RN can get accurate and up-to-date information on the legal scope of practice for LPNs in Arkansas. This ensures compliance with state regulations and avoids any potential legal issues. A: Querying the state nursing association may provide some insight, but the state board of nursing is the official entity that regulates nursing practice. B: Asking the LPNs about their tasks may not provide a comprehensive understanding of their legal scope of practice and could lead to misunderstandings. D: Referring to California's nurse practice act is irrelevant as each state has its own regulations, and assuming consistency across states can lead to incorrect assumptions.

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