Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)?

Correct Answer: D

Rationale: The correct answer is D because an elevated BUN level of 52 mg/dL indicates potential kidney dysfunction, which is a contraindication for metformin due to the risk of lactic acidosis. A: Blood glucose level of 174 mg/dL is slightly high but not a contraindication for metformin. B: Weight gain is unrelated to metformin administration. C: Chest x-ray does not directly impact metformin administration.

Correct Answer: D

Rationale: The correct answer is D: Representation election. This process involves selecting a person or unit to negotiate on behalf of a group, typically in labor unions. It is a democratic way for employees to choose their representatives. Labor negotiations (A) are the actual discussions between parties, bargaining (B) refers to the process of reaching an agreement, and establishing a union (C) is the formation of a collective bargaining unit, all of which are steps that come after selecting the representative through a representation election.

Correct Answer: A

Rationale: The correct answer is A because the primary goal of nursing is to provide holistic care, which includes helping patients achieve a peaceful death. This involves promoting comfort, dignity, and emotional support for patients and their families at the end of life. Choice B focuses on personal development, not the primary goal of nursing. Choice C emphasizes quality of life, which is important but not the primary goal. Choice D prioritizes cost control, which is not the central focus of nursing care. Overall, assisting patients to achieve a peaceful death reflects the essence of nursing care and the importance of compassion and support in end-of-life situations.

Correct Answer: C

Rationale: The correct answer is C: Diagnose the problem. In Lippitt's phases of change, this phase involves key people in data collection to identify the root cause of the issue. Assessing motivation (A) comes before diagnosing the problem, choosing a change agent (B) is about selecting a person to lead the change effort, and maintaining the change (D) occurs after implementation. Diagnosing the problem is crucial as it sets the foundation for developing effective strategies to address the identified issues.

Correct Answer: A

Rationale: Correct Answer: A: Designate specific time slots for drop-in visits. Rationale: 1. Designating specific time slots for drop-in visits allows for better time management by setting boundaries and expectations. 2. It helps staff members plan their interactions with the Nurse Manager, reducing interruptions throughout the day. 3. This method promotes efficiency and productivity by consolidating similar tasks into designated blocks of time. Summary of other choices: B: Position the desk chair so it is not facing the hallway - This may help reduce distractions but does not directly address time management. C: Communicate with staff about using e-mail for non-urgent matters to improve time management - While this is a good practice, it does not specifically address the issue of inordinate time spent on drop-in visits. D: When staff members drop in, the manager should stand and remain standing during the conversation - Standing may convey urgency, but it does not provide a structured approach to managing time effectively.

Correct Answer: A

Rationale: The correct answer is A: Hydrocolloid dressing. For a stage 2 pressure injury, a hydrocolloid dressing is ideal as it maintains a moist environment to promote healing, absorbs excess exudate, and provides a barrier against bacteria. Transparent dressings (B) are more suitable for superficial wounds. Gauze dressings (C) may adhere to the wound bed and cause trauma upon removal. Alginate dressings (D) are better for wounds with heavy exudate, not typically seen in stage 2 pressure injuries.

Correct Answer: A

Rationale: The correct answer is A: Alcohol or drug withdrawal. This is because individuals experiencing withdrawal from alcohol or drugs may exhibit aggressive behavior due to physical and psychological effects of withdrawal. This can lead to volatile and potentially violent situations. Choice B: Anxiety, and choice C: Depression, are less likely to be directly associated with violent behavior compared to withdrawal symptoms. Choice D: Confusion, while it can lead to misunderstandings or agitation, is not as consistently linked to violent behavior as alcohol or drug withdrawal. Therefore, staff should be more prepared to manage and diffuse potentially violent situations when dealing with individuals experiencing alcohol or drug withdrawal.

Correct Answer: D

Rationale: The correct answer is D: affinity map. When a problem is not easily identified, using an affinity map can help organize and visually represent different ideas or information related to the issue. This method allows for clustering similar themes or concepts, leading to a clearer understanding of the problem. A: Trial and error involves randomly trying different solutions without a systematic approach. B: The Delphi method is a structured communication technique for gathering opinions from experts, which may not directly help in identifying the problem. C: Political decision-making model focuses on power dynamics and interests, which may not be relevant for problem identification. In summary, using an affinity map promotes structured organization of information, making it the most suitable choice for identifying unclear problems.

Correct Answer: B

Rationale: The primary responsibility of a clinical nurse leader (CNL) is to coordinate patient care. This involves overseeing the care provided to patients, ensuring proper communication between healthcare team members, and promoting efficient and effective care delivery. CNLs focus on improving patient outcomes and quality of care by coordinating various aspects of patient care. Supervising nursing staff (A) is typically the responsibility of nurse managers or charge nurses. Developing nursing policies (C) is usually the role of nurse educators or nurse administrators. Implementing evidence-based practice (D) is important for all nurses but is not the primary responsibility of a CNL, whose main focus is on coordinating patient care.