Correct Answer: C

Rationale: The correct answer is C: Ensuring proper documentation of client services. Proper documentation is crucial for accurate billing, resource allocation, and reimbursement. By documenting services accurately, the unit can avoid financial losses due to underbilling or denials. It also helps in identifying areas for improvement and optimizing resource utilization.

A: Implementing rigid yearly budget planning may limit flexibility and hinder responsiveness to changing needs.
B: Maintaining budget planning between senior leadership is important but doesn't directly address cost containment.
D: Increasing the unit budget above expected needs is not cost-effective and may lead to wasteful spending.

Correct Answer: A

Rationale: The correct answer is A: Social worker. A social worker is essential in managing oppositional defiant disorder as they can provide counseling, support, and resources for the child and family. Social workers specialize in addressing social and emotional factors contributing to the child's behavior. Physical therapists focus on physical movement and rehabilitation, not behavior. Occupational therapists work on improving daily living skills. Speech pathologists address communication disorders. In this case, the social worker is the most appropriate choice for addressing the child's behavioral challenges.

Correct Answer: D

Rationale: The correct answer is D: An adolescent client whose parents refuse a blood transfusion for religious reasons. Collaboration with the ethics committee is necessary because this situation involves potential conflict between the client's best interest and parental beliefs. The ethics committee can provide guidance on legal and ethical considerations, ensuring the adolescent's rights are upheld.
Choice A does not require ethics committee involvement as the client has the right to leave against medical advice.
Choice B indicates the client's wishes are clear with advance directives.
Choice C involves informed consent for research study participation, not necessarily requiring ethics committee input.

Correct Answer: C

Rationale: The correct answer is C: A client who has a compromised airway. Assigning a red tag indicates the client needs immediate attention and is the highest priority. A compromised airway is life-threatening and requires urgent interventions to maintain adequate oxygenation. Other choices are incorrect because fixed pupils (
A) may indicate neurological issues but do not necessarily require immediate intervention, brief loss of consciousness (
B) may need evaluation but is not as critical as a compromised airway, and major burns covering 70% of the body (
D) are serious but do not pose an immediate threat to the airway.

Correct Answer: B

Rationale: The correct answer is B: State nurse practice act. Nurses must abide by the laws and regulations outlined in the state nurse practice act, which governs their scope of practice. Removing chest tubes falls under nursing interventions and is subject to state regulations. Consulting the state nurse practice act ensures the nurse is complying with legal requirements and can perform the procedure safely and within their scope of practice. The other options, while important, do not specifically address the legal authority and scope of practice related to chest tube removal. The Institute of Medicine focuses on healthcare quality and safety, the ANA Standards of Practice provide guidelines for nursing care, and the ANA Code of Ethics outlines ethical principles for nursing practice. However, when considering a specific nursing procedure like removing chest tubes, the state nurse practice act takes precedence in providing legal guidance.