What behaviors can be observed before a person becomes violent? (EXCEPT)

Correct Answer: A

Rationale: The correct answer is A because wandering is not typically associated with violent behavior. Tense shoulders and clenched fists (B), blank stare (C), and positioned with one foot in back and an arm pulled back (D) are commonly observed behaviors before a person becomes violent. Tense shoulders and clenched fists indicate agitation, a blank stare can indicate aggression, and the specific body positioning described in D suggests readiness for physical aggression. Wandering, however, is more likely to indicate confusion or aimlessness rather than impending violence.

Correct Answer: D

Rationale: The correct answer is D: Contingency theory. Contingency theory suggests that there is no one best way to organize and manage a healthcare system. It emphasizes that the effectiveness of a healthcare delivery system depends on various factors such as the environment, technology, and organizational structure. This theory acknowledges the complexity of healthcare systems and the need for flexibility and adaptation to changing circumstances. A: Open system theory focuses on the system's interaction with its environment, but it does not specifically address the best way to organize and manage a healthcare system. B: Closed system theory suggests that a system is self-contained and not influenced by external factors, which is not suitable for describing healthcare delivery systems. C: Chaos theory emphasizes the unpredictability and complexity of systems, but it does not provide a framework for organizing and managing healthcare systems effectively.

Correct Answer: A

Rationale: The correct answer is A: Statutory laws. Nursing practice is primarily governed by statutory laws, which are laws created by legislative bodies. These laws outline the scope of practice, licensure requirements, and regulations for nursing professionals. Common laws (B) are based on court decisions and do not specifically govern nursing practice. Administrative laws (C) regulate administrative agencies and their functions, not nursing practice. Constitutional laws (D) pertain to the constitution and the rights of individuals, not the specific regulations for nursing practice.

Correct Answer: C

Rationale: The correct answer is C because an elderly client awaiting a hip replacement typically requires ongoing support and coordination of services, making them a good candidate for case management. This client would benefit from assistance with navigating the healthcare system, coordinating appointments, and ensuring continuity of care post-surgery. Choice A is incorrect as the adolescent with a gunshot wound in the ER is likely to be in need of immediate medical intervention rather than case management. Choice B is incorrect as a young adult with a fractured pelvis may require medical treatment but may not necessarily need the level of ongoing support that case management provides. Choice D is incorrect as a 41-year-old client admitted for an outpatient tonsillectomy is a relatively straightforward procedure that may not require extensive case management services.

Correct Answer: A

Rationale: The correct answer is A: Unfreeze the system. According to Lewin's Change Theory, the first step in the change process is to unfreeze the current state or system to prepare for change. This involves creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Moving the system to a new level (choice B) and refreezing the system (choice C) are subsequent steps in the change process after unfreezing. Evaluating the system (choice D) comes later in the process to assess the effectiveness of the change implemented. Therefore, unfreezing the system is the critical initial step to facilitate successful change implementation.

Correct Answer: C

Rationale: The correct answer is C: medical-legal incident. When a client discharges AMA, it poses medical-legal risks for healthcare providers. This includes potential liability if the client experiences adverse outcomes post-discharge. Other choices are incorrect because discharging AMA is not solely focused on nurses (A) or physicians (B), but involves legal implications. It is also not purely patient-focused (D) as it impacts the healthcare team's legal responsibilities.

Correct Answer: C

Rationale: The correct answer is C: Shared decision making. Shared governance involves collaborative decision-making among healthcare professionals, including nurses, to improve patient care and organizational outcomes. This approach empowers frontline staff to have a voice in decisions that affect their work environment and patient care. Nurse-led committees (option B) may be a part of shared governance but do not fully encompass the concept. Top-down management (option A) and hierarchical structure (option D) are opposite to the principles of shared governance as they involve centralized decision-making and lack of employee involvement in decision-making processes.

Correct Answer: D

Rationale: The correct answer is D: Patient-focused. Developing a patient-focused atmosphere is crucial to reduce potential risks in healthcare. Patients should be at the center of care, with their needs, preferences, and safety prioritized. In a patient-focused atmosphere, communication is enhanced, leading to better understanding and adherence to treatment plans, reducing errors and adverse events. Nurses, physicians, and families play important roles in patient care, but ultimately, the patient should be the primary focus. Incorrect choices: A: Nurse-focused - Focusing solely on nurses may neglect the holistic approach to patient care and fail to address the patient's needs directly. B: Physician-focused - Similarly, focusing only on physicians may lead to a lack of patient involvement in decision-making and may not address the emotional and psychological aspects of care. C: Family-focused - While involving families in care is important, solely focusing on them may not always align with the patient's best interests and may not address the patient's autonomy and individual needs.

Correct Answer: A

Rationale: The correct answer is A: Assist the client with a partial bed bath. This task can be safely delegated to an assistive personnel (AP) because it does not require any specialized medical knowledge or skills. The AP can follow standard protocols and guidelines to assist the client with personal hygiene while ensuring safety and comfort. Choice B is incorrect because measuring the client's BP after administering medication requires clinical judgment and knowledge to interpret the results. Choice C is incorrect as testing swallowing ability involves potential risks and requires specialized training to prevent aspiration. Choice D is incorrect as using a communication board involves understanding the client's needs and preferences, which may require communication skills and knowledge of aphasia management.