Nurses on the dialysis unit notice that changes in labeling of fluids have meant several alarming near misses in terms of wrong administration of fluids. They take this concern to the unit manager. As an advocate of nurse autonomy, the most appropriate response in this situation would be to:

Correct Answer: B

Rationale: Supporting nurse autonomy means empowering staff to influence their practice. Discussing label concerns and co-developing solutions some local (e.g., unit protocols), some systemic (e.g., pharmacy changes) respects their expertise and fosters ownership, aligning with autonomy's emphasis on decision-making. Explaining the change informs but doesn't engage them. Waiting delays action on a safety issue, and deferring to pharmacy sidelines nurses. This collaborative approach, backed by research (e.g., Kramer), enhances satisfaction and safety, making it the most appropriate response.

Correct Answer: C

Rationale: The Quality and Safety Education for Nurses (QSEN) initiative defines quality improvement as using data to monitor outcomes and improve care processes. Tracking postoperative pain management outcomes involves collecting and analyzing data to assess effectiveness, identify trends, and refine interventions, directly reflecting the quality improvement competency. Patient-centered care focuses on individual preferences, not outcome tracking, while teamwork and collaboration emphasize interpersonal dynamics, not data analysis. Safety prioritizes error prevention, but this scenario centers on evaluating care results, not just safety breaches. Quality improvement's focus on data-driven enhancement makes it the best fit, as the nurse's activity aims to optimize pain management protocols, enhancing overall client care quality.

Correct Answer: A

Rationale: Before morphine for pain, RR 10 requires holding and notifying, not BP 120/80, HR 90, or pain 8/10. Opioids depress breathing below 12 risks apnea, especially acute. Vitals are fine, pain's expected. Leadership checks this imagine drowsiness; it prevents overdose, aligning with pain care effectively.

Correct Answer: C

Rationale: A reactive nonstress test at 36 weeks showing fetal heart accelerations means reassurance is apt, not repeat testing, oxytocin, or C-section. It signals fetal well-being; no distress warrants intervention. In nursing leadership, interpreting this correctly avoids unnecessary escalation imagine a worried mother; calm explanation eases her, reflecting evidence-based care. Repeating or escalating suggests misreading reactivity, risking over-treatment. This decision upholds safety and trust, guiding obstetric nurses to support normalcy when data aligns, critical in late pregnancy management.

Correct Answer: A

Rationale: Democratic style splits power A is correct. Nurse leaders share decisions, like staff input on schedules, contrasting with dictatorial control. In healthcare, this fosters collaboration and morale, unlike autocracy's rigidity. It aligns leadership with inclusion, ensuring diverse voices improve patient care outcomes.

Correct Answer: A

Rationale: Mentoring lets Jenna develop leadership guiding novices hones skills like communication and decision-making, key for growth. It's less about clinical expertise (already solid at 5 years), quick promotion (indirect), or peer authority (not the focus). In appraisals, this goal signals ambition to lead, as mentoring builds confidence and influence, preparing her for bigger roles while supporting staff, a win-win for her and the unit.

Correct Answer: B

Rationale: A pain scale and training enhance pain management, showing patient-centered care consistent assessment relieves suffering, meeting needs. It's not oversight, dissatisfaction, or shirking staff lead. In the meeting, this prioritizes comfort, aligning with care quality, engaging peers to boost relief and satisfaction, a nurse-driven fix rooted in patient focus.

Correct Answer: A

Rationale: Furosemide, a loop diuretic, treats fluid overload but depletes electrolytes, notably potassium, risking hypokalemia muscle cramps, arrhythmias especially critical with cardiac clients. Monitoring potassium (normal 3.5-5.0 mEq/L) is essential, as the drug's action inhibits reabsorption in the loop of Henle, increasing urinary loss, often requiring supplementation or dietary adjustment. Hemoglobin reflects anemia, not directly affected, while cholesterol and blood glucose aren't primary concerns furosemide doesn't target lipids or sugar. Potassium monitoring detects imbalances early, guiding interventions like potassium-rich foods or IV replacement, aligning with the nurse's role in safe medication management, preventing life-threatening complications, and ensuring therapeutic efficacy in a client new to this potent diuretic.

Correct Answer: A

Rationale: Justice in nursing ethics means fair, equitable treatment for all. The statement I will compose staff schedules so that each person works two holidays a year' reflects this by distributing holiday shifts evenly, ensuring no one is disproportionately burdened, aligning with impartial resource allocation. Favoring certain staff violates fairness, prioritizing personal bias over equity. Scheduling by seniority alone discriminates against newer staff, while letting staff pick holidays risks imbalance if some are over- or under-assigned. The equal distribution approach demonstrates understanding of justice, fostering a supportive team environment, reducing resentment, and upholding ethical leadership, making it a clear indicator of the principle's application in practice.