Six months ago a medical-surgical unit established a series of rules for staff and patients regarding noise and patient interruption between 10 p.m. and 6 a.m. Several nurses want to evaluate the impact of these rules to ensure the changes have met the patients' needs and perform some EBR into these outcomes. Some nurses want to use a survey with all the patients. However, others think that better data might be captured by interviewing a few patients. Which research methods would be best for this situation?

Correct Answer: C

Rationale: The correct answer, C) mixed methods, is the best choice for evaluating the impact of the established rules on the medical-surgical unit. Mixed methods research allows for a comprehensive approach by combining qualitative methods (interviews) and quantitative methods (surveys). Using only qualitative methods (option A) such as interviews may provide in-depth insights into patient experiences, but quantitative data from surveys (option B) can offer a broader perspective and help identify trends and patterns. Thus, a combination of both approaches through mixed methods is ideal for a more robust and holistic evaluation. Selecting option D, stating all methods are equally appropriate, is not accurate in this context. Using only one type of research method may limit the scope and depth of the evaluation. By choosing mixed methods, nurses can gather a wide range of data to understand the impact of the rules on patient needs thoroughly. Educationally, understanding the importance of selecting the appropriate research method is crucial for nurses to conduct evidence-based practice and improve patient care. By utilizing mixed methods, nurses can gain a more comprehensive understanding of the situation, leading to more informed decision-making and better outcomes for patients.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer because the inability of the RN to provide adequate supervision to the AP is a crucial factor in determining whether delegation is appropriate. Delegation in nursing requires the delegating nurse, in this case, the RN, to provide clear instructions, adequate supervision, and follow-up to ensure safe and effective patient care. Without the ability to supervise the AP, the RN cannot ensure that the lab draws will be performed accurately and safely. Option A is incorrect because completing competencies for lab draws is necessary but not sufficient for delegation. Regular practice and ongoing competency maintenance are equally important for safe delegation of tasks. Option C is incorrect because the ability of the RN to obtain the lab draws without delegation does not address the issue of whether delegation to the AP is appropriate based on supervision capabilities. Option D is incorrect because the RN not having worked directly with the AP before is not the primary reason preventing delegation. The key factor is the RN's ability to provide adequate supervision, regardless of prior work experience with the AP. In an educational context, understanding the principles of delegation in nursing is essential for safe and effective patient care. Nurses need to know when and how to delegate tasks appropriately, considering factors such as competence, supervision, and accountability. By grasping these concepts, nurses can uphold standards of care and promote patient safety in healthcare settings.

Correct Answer: C

Rationale: The correct answer is C) speech therapist. Speech therapists are trained to evaluate and treat swallowing difficulties, also known as dysphagia. They possess the expertise in assessing the patient's ability to swallow, identifying any issues or risks, and developing appropriate interventions to improve swallowing function. In this scenario, the nurse's observation of the patient having difficulty swallowing necessitates the involvement of a speech therapist to conduct a thorough evaluation and provide targeted interventions. Option A) occupational therapist and option B) physical therapist are not the ideal choices for evaluating swallowing difficulties. While occupational therapists and physical therapists play essential roles in rehabilitation and promoting functional independence, they do not have the specialized training in assessing and treating dysphagia. Option D) respiratory therapist primarily focuses on assessing and treating respiratory conditions, such as asthma or COPD, rather than swallowing difficulties. It is crucial for healthcare professionals to recognize the scope of practice of each interprofessional team member to ensure that patients receive the most appropriate care. Educationally, understanding the roles of different interprofessional team members is crucial for providing comprehensive and patient-centered care. By correctly identifying the appropriate specialist for a particular issue, healthcare professionals can collaborate effectively and optimize patient outcomes. This scenario highlights the importance of interdisciplinary communication and teamwork in addressing complex patient needs.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) hepatitis B. The patient's Vietnamese background and family history of liver cancer indicate a higher risk for hepatitis B infection, which is a common cause of liver cancer, especially in Asian populations. Understanding the cultural and genetic factors at play is crucial in providing client-centered care in nursing. Option B) malaria is incorrect because malaria is a parasitic infection transmitted through mosquitoes and is not directly related to the patient's family history of liver cancer. Option C) tularemia is incorrect as it is a bacterial infection typically transmitted through animals like rabbits or ticks, and is not associated with the patient's familial risk of liver cancer. Option D) tyrosinemia is incorrect as it is a rare genetic disorder that affects the body's ability to break down the amino acid tyrosine, and is not linked to the patient's increased risk of hepatitis B due to their family history of liver cancer. Educationally, this question highlights the importance of considering a patient's cultural background and family history in assessing their risk factors for certain health conditions. By recognizing the connection between hepatitis B and liver cancer in Asian populations, nurses can provide targeted education, screening, and interventions to promote preventative care and early detection in at-risk individuals.

Correct Answer: B

Rationale: The correct answer is B) cocaine. Cocaine is a potent stimulant that produces sympathomimetic effects on the body, such as tachycardia (rapid heart rate), dilated pupils, and euphoria. These symptoms align with the presentation of the 42-year-old patient with epistaxis (nosebleed), dilated pupils, tachycardia, and mild euphoria. Additionally, epistaxis is a common side effect of cocaine use when it is insufflated through the nose. Option A) alprazolam (Xanax) is a benzodiazepine used to treat anxiety disorders and does not typically produce the symptoms described. Option C) morphine sulfate (MS Contin) and option D) oxycodone hydrochloride (Oxycontin) are opioids that would not typically cause the combination of symptoms seen in this patient, as they are more likely to cause respiratory depression rather than tachycardia and dilated pupils. In an educational context, understanding the effects of different drugs on the body is crucial for healthcare professionals, especially nurses, who play a vital role in patient care and assessment. Recognizing the signs and symptoms of drug use or overdose is essential for providing appropriate care and interventions. This question highlights the importance of clinical knowledge and critical thinking skills in assessing and managing patients with substance use-related presentations.