Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
The charge nurse on the renal unit is notified of a bus accident with multiple injuries, and clients are being brought to the emergency department (ED). The hospital is implementing the disaster policy. Which action should the charge nurse take first?
A. call any off-duty nurses to notify them to come in to work.
This action is premature because activating off-duty staff occurs after assessing internal capacity. Disaster response prioritizes immediate resource optimization within existing staffing before expanding workforce availability.
B. Determine which clients could be discharged home immediately.
This action is correct because identifying clients who can be safely discharged immediately increases bed availability, supports surge capacity, and ensures rapid accommodation of incoming mass casualty victims from the bus accident.
C. Assess the staffing to determine which staff could be sent to the ED.
This action is secondary because staffing adjustments to the ED are important but follow initial capacity creation steps. Bed availability must be addressed first to ensure proper patient placement before reallocating personnel.
D. Request all visitors to leave the hospital as soon as possible.
This action is incorrect as visitor restriction may be part of disaster protocols but does not directly address immediate surge capacity needs. The priority is freeing inpatient beds to receive incoming critically injured clients.
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Full Explanation
Disaster management in healthcare follows structured principles of surge capacity, resource reallocation, client prioritization, and rapid bed availability creation, focusing first on increasing treatment space and capacity for incoming mass casualty victims while maintaining safe ongoing inpatient care.
Rationale:
A. This action is premature because activating off-duty staff occurs after assessing internal capacity. Disaster response prioritizes immediate resource optimization within existing staffing before expanding workforce availability.
B. This action is correct because identifying clients who can be safely discharged immediately increases bed availability, supports surge capacity, and ensures rapid accommodation of incoming mass casualty victims from the bus accident.
C. This action is secondary because staffing adjustments to the ED are important but follow initial capacity creation steps. Bed availability must be addressed first to ensure proper patient placement before reallocating personnel.
D. This action is incorrect as visitor restriction may be part of disaster protocols but does not directly address immediate surge capacity needs. The priority is freeing inpatient beds to receive incoming critically injured clients.
Similar Questions
A nurse is teaching a client who has osteoarthritis of the hip and knee about self-management of the disease. Which statements should the nurse include in the teaching? Select All That Apply.
A. "Apply heat to your joints to alleviate pain."
This is correct because heat therapy promotes vasodilation, reduces joint stiffness, improves synovial fluid viscosity, and decreases pain perception in chronic degenerative joint disease, improving functional mobility in osteoarthritis.
B. Use a firm mattress for sleeping."
This is correct because a firm mattress supports spinal alignment and reduces joint stress during sleep. It helps prevent abnormal joint positioning and minimizes morning stiffness commonly seen in osteoarthritic joints.
C. "Sleep with a pillow under your knees."
This is incorrect because placing a pillow under the knees promotes knee flexion contractures, reduces joint extension, and worsens long-term deformity in osteoarthritis, especially in weight-bearing joints already prone to stiffness and limited range of motion.
D. "Avoid bending your joints to the point where they become painful when exercising."
This is correct because avoiding pain-induced joint stress during exercise prevents further cartilage degeneration and inflammation. Exercise should remain within a tolerable range to maintain mobility without exacerbating joint destruction and synovial irritation.
E. "Take tub baths instead of showers."
This is incorrect because tub baths increase risk of falls, especially in clients with reduced mobility and joint instability. Safer alternatives include showers with assistive devices, as osteoarthritis impairs balance and lower extremity strength.
Full Explanation
Osteoarthritis (OA) is a chronic degenerative joint disorder characterized by cartilage breakdown, synovial inflammation, osteophyte formation, and progressive joint space narrowing, leading to pain, stiffness (especially after inactivity), decreased mobility, and functional impairment primarily in weight-bearing joints such as hips and knees.
Rationale:
A. This is correct because heat therapy promotes vasodilation, reduces joint stiffness, improves synovial fluid viscosity, and decreases pain perception in chronic degenerative joint disease, improving functional mobility in osteoarthritis.
B. This is correct because a firm mattress supports spinal alignment and reduces joint stress during sleep. It helps prevent abnormal joint positioning and minimizes morning stiffness commonly seen in osteoarthritic joints.
C. This is incorrect because placing a pillow under the knees promotes knee flexion contractures, reduces joint extension, and worsens long-term deformity in osteoarthritis, especially in weight-bearing joints already prone to stiffness and limited range of motion.
D. This is correct because avoiding pain-induced joint stress during exercise prevents further cartilage degeneration and inflammation. Exercise should remain within a tolerable range to maintain mobility without exacerbating joint destruction and synovial irritation.
E. This is incorrect because tub baths increase risk of falls, especially in clients with reduced mobility and joint instability. Safer alternatives include showers with assistive devices, as osteoarthritis impairs balance and lower extremity strength.
A client has been prescribed norepinephrine 152 mcg. The concentration of norepinephrine is 8 mg mixed in 250 mL of DSW. How many mL should the nurse administer? Round to the whole number.
Full Explanation
Step 1: Identify desired dose and concentration
Desired dose = 1,152 mcg, Concentration = 8 mg / 250 mL
Step 2: Use the formula First, convert mg to mcg to match units:
8 mg×1,000=8,000 mcg
Calculate concentration per mL: 8,000 mcg÷250 mL=32 mcg/mL Volume (mL) = Desired dose ÷ Concentration
Step 3: Insert values =1,152÷32
Step 4: Calculate =36 mL
Step 5: Round to the whole number =36
A nurse accuses a newly licensed nurse of providing inadequate care for a client who underwent hip arthroplasty. Which response by the newly licensed nurse demonstrates assertiveness?
A. "I am sorry you are displeased. I always do my best to give good care to my clients."
This response reflects passive communication, showing apology and self-doubt without addressing the accusation directly. It fails to advocate for professional practice or seek clarification, making it inconsistent with assertive behavior.
B. "I feel as though I met the standard of care. Would you tell me more about your concerns?"
This response demonstrates assertive communication by clearly stating confidence in meeting standards while inviting further discussion. It balances self-advocacy with openness, promoting professional dialogue and resolution of concerns respectfully.
C. "Yes, you might be right. I haven't had the best role models since I started this position."
This response reflects passive acceptance of blame and externalizes responsibility to poor role models. It lacks professional confidence and does not defend practice or engage constructively, making it non-assertive and professionally inappropriate.
D. "You shouldn't make accusations. Your nursing care doesn't always set a good example."
This response is aggressive communication, as it involves blaming and counter-accusation toward the other nurse. It escalates conflict rather than promoting resolution, and it violates principles of professional respectful communication in nursing practice.
Full Explanation
Assertive communication in nursing is characterized by direct expression, professional confidence, respect for others, and constructive dialogue, allowing nurses to advocate for themselves while seeking clarification and maintaining therapeutic and collegial relationships without aggression or passivity.
Rationale:
A. This response reflects passive communication, showing apology and self-doubt without addressing the accusation directly. It fails to advocate for professional practice or seek clarification, making it inconsistent with assertive behavior.
B. This response demonstrates assertive communication by clearly stating confidence in meeting standards while inviting further discussion. It balances self-advocacy with openness, promoting professional dialogue and resolution of concerns respectfully.
C. This response reflects passive acceptance of blame and externalizes responsibility to poor role models. It lacks professional confidence and does not defend practice or engage constructively, making it non-assertive and professionally inappropriate.
D. This response is aggressive communication, as it involves blaming and counter-accusation toward the other nurse. It escalates conflict rather than promoting resolution, and it violates principles of professional respectful communication in nursing practice.