Whats your Conflict???
"There is confusion as to whether it is the responsibility of the nursing unit or dietary department to pass meal trays to clients" This represents what type of conflict category?
A. Intrapersonal Conflict
B. Interpersonal Conflict
C. Preceived Conflict
D. Intergroup Conflict
What is D. Intergroup Conflict Occurs between two or more groups of individuals, departments, or organizations and can be caused by a new policy or procedure, a change in leadership, or a change in organizational structure.
The elderly female client fell and fractured her left femur. The nurse finds the client crying, and she tells the nurse, “I don’t want to go to the nursing home but my son says I have to.” Which response would be most appropriate by the nurse?
1. “Let me call a meeting of the health-care team and your son.”
2. “Has the social worker talked to you about this already?”
3. “Why are you so upset about going to the nursing home?”
4. “I can see you are upset. Would you like to talk about it?”
What is 4. “I can see you are upset. Would you like to talk about it?” According to the NSCBN NCLEX-RN test plan, advocacy is part of the management of care under the safe and effective care environment. Therapeutic communication involves being an advocate in this situation because sometimes the nurse cannot prevent a perceived “bad” situation from occurring.
The client in labor is showing late decelerations on the fetal monitor. Which intervention should the nurse implement first?
1. Notify the health-care provider (HCP) immediately.
2. Instruct the client to take slow, deep breaths.
3. Place the client in the left lateral position.
4. Prepare for an immediate delivery of the fetus.
What is 3. Place the client in the left lateral position. The left lateral position will improve placental blood flow and oxygen supply to the fetus. This should be the nurse’s first intervention.
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1. The nurse should first intervene to increase blood supply to the fetus; therefore, notifying the HCP is not the nurse’s first intervention.
2. Slow, deep breaths may help decrease the mother’s anxiety, but the nurse’s first intervention is to increase blood supply to the fetus.
4. The nurse should prepare for an emergency C-section, but this is not the nurse’s first intervention.
Which medication should the nurse administer first after receiving the morning shift report?
1. The IVPB antibiotic to the client admitted at 0530 this morning.
2. The sliding scale short-acting insulin to the client with diabetes.
3. The non-narcotic pain medication to a client with a headache.
4. The proton-pump inhibitor to the client with a peptic ulcer.
What is 1. The IVPB antibiotic to the client admitted at 0530 this morning. First-dose intravenous antibiotic medications are priority medications and should be administered within 1 to 2 hours of when the order was written. This should be the first medication administered.
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2. This is an important medication and should be administered before the breakfast meal, but it is not priority over initiating the intravenous antibiotic treatment.
3. The client should be medicated but not before initiating the intravenous antibiotic.
4. This medication can be administered within the allowable 30 minutes before and after the scheduled administration time.
What is the mechanism of action for Famotidine?
A. It causes a decrease in stomach pH, reducing stomach acidity.
B. It competes with histamine for binding sites on the parietal cells.
C. It forms a protective coating against gastric acid, pepsin, and bile salts.
D. It irreversibly binds to the hydrogen–potassium–adenosine triphosphatase (ATPase) pump.
What is B. It competes with histamine for binding sites on the parietal cells. Histamine receptor–blocking drugs decrease gastric acid by competing with histamine for binding sites on the parietal cells.
"A new nurse is given a client assignment that is heavier than those of other nurses, and when he asks for help, it is denied" This example represents which conflict category?
A. Intrapersonal Conflict
B. Interpersonal Conflict
C. Preceived Conflict
D. Latent Conflict
What is B. Interpersonal Conflict Occurs between two or more people with differing values, goals, or beliefs.
●Interpersonal conflict in the health care setting involves disagreement among nurses, clients, family members, and within a health care team. Bullying and incivility in the workplace are forms of interpersonal conflict.
● This is a significant issue in nursing, especially in relation to new nurses, who bring new personalities and perspectives to various health care settings.
● Interpersonal conflict contributes to burnout and work‑related stress.
The female client in the preoperative holding area tells the nurse that she had a reaction to a latex diaphragm. Which intervention should the nurse perform first?
1. Notify the operating room personnel.
2. Label the client’s chart with the allergy.
3. Place a red allergy band on the client.
4. Inform the client to tell all HCPs of the allergy.
What is 1. Notify the operating room personnel. Because the client is in the preoperative holding area, the immediate safety need for the client is to inform the operating room personnel so that no latex gloves or equipment will come into contact with the client. Person-to-person communication for a safety issue ensures that the information is not overlooked.
The nurse walks into the client’s room to check on the mother and her newborn. The client states another nurse just took her baby back to the nursery. Which intervention should the nurse implement first?
1. Initiate an emergency Code Pink, indicating an infant abduction.
2. Request the mother to describe the nurse who took the baby.
3. Determine whether or not the infant was returned to the nursery.
4. Ask the mother whether the nurse asked for the code word.
What is 3. Determine whether or not the infant was returned to the nursery. The nurse should first determine whether another staff member returned the infant to the nursery. The nurse should not call a false alarm.
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1. Once the nurse definitely determines the infant is not in the nursery, then a Code Pink should be initiated. This notifies all hospital personnel of a possible infant abduction.
2. This will be done if the infant was not returned to the nursery, but this is not the first intervention.
4. There are many safety precautions to prevent infant abductions, and most facilities have a code word that is changed daily. The mother must ask anyone who wants to take the infant out of the mother’s room for the code word. This is not the nurse’s first intervention.
The UAP accidentally pulled the client’s chest tube out while assisting the client to the bedside commode (BSC). Which intervention should the nurse implement first?
1. Securely tape petroleum gauze over the insertion site.
2. Instruct the UAP how to move a client with a chest tube.
3. Assess the client’s respirations and lung sounds.
4. Page the physician and obtain a chest tube and a chest tube insertion tray.
What is 1. Securely tape petroleum gauze over the insertion site. Taping petroleum gauze over the chest tube insertion site will prevent air from entering the pleural space. This is the first intervention.
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2. The nurse should make sure the UAP knows the correct method to assist a client with a chest tube, but the safety of the client is the first priority.
3. This is the second intervention the nurse should implement. Remember, if the client is in distress and the nurse can do something to relieve that distress, then the nurse should not assess first. The nurse should take action to take care of the client.
4. The nurse should obtain the necessary equipment for the HCP to reinsert the chest tube, but the priority intervention is to prevent air from entering the pleural space.
How will the nurse describe the action of proton pump inhibitors (PPIs)?
A. They compete with histamine for binding sites on the parietal cells.
B. They form a protective barrier that can be thought of as a liquid bandage.
C. They irreversibly bind to the hydrogen-potassium-ATPase pump.
D. They help to neutralize acid secretions to promote gastric mucosal defensive mechanisms.
What is C. They irreversibly bind to the hydrogen-potassium-ATPase pump. PPIs work to block the final step in the acid-secreting mechanisms of the proton pump. They do this by irreversibly binding to the ATPase pump, H+/K+ ATPase, the enzyme for this step.
The director of nurses in the clinic is counseling a unlicensed assistive personnel (UAP) in the clinic who returned late from her lunch break seven times in the last 2 weeks. Which conflict resolution utilizes the win-lose strategy?
1. The UAP explains she is checking on her ill mother during lunch, and the nurse allows her to take a longer lunch break if she comes in early.
2. The director of nurses offers the UAP a transfer to the emergency weekend clinic so that she will be off during the week.
3. The director of nurses terminates the UAP explaining that all staff must be on time so that the clinic runs smoothly.
4. The UAP is placed on 1-month probation, and any further occurrences will result in being terminated from this position.
What is: 3. The director of nurses terminates the UAP explaining that all staff must be on time so that the clinic runs smoothly. This is a win-lose strategy in which during the conflict one party (the director of nurses) exerts dominance and the other party (UAP) must submit and loses.
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1. This is a win-win strategy which focuses on goals (to have adequate staff) and attempts to meet the needs of both parties. The director of nurses keeps an experienced nurse, and the UAP keeps her position. Both parties win. 2. This is a possible win-win strategy in which both parties win. The UAP keeps her job, and the director of nurses can hire a UAP who will be able to work the assigned hours. 4. This is negotiation in which the conflicting parties give and take on the issues. The UAP gets one more chance, and the director of nurse’s authority is still intact.
Assertive Communication includes (Select all that apply):
A. Use of assertive communication can be necessary during conflict negotiation.
B. Assertive communication allows expression in direct, honest, and threatening ways that do not infringe upon the rights of others.
C. It is a communication style that acknowledges and deals with conflict, recognizes others as equals, and provides a direct statement of feelings.
What is A & C
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B. Assertive communication allows expression in direct, honest, and NON-threatening ways that do not infringe upon the rights of others.
The nurse working in a women’s health clinic is returning telephone calls. Which client should the nurse contact first?
1. The 16-year-old client who is complaining of severe lower abdominal cramping.
2. The 27-year-old primigravida client who is complaining of blurred vision.
3. The 48-year-old perimenopausal client who is expelling dark red blood clots.
4. The 68-year-old client who thinks her uterus is falling out of her vagina.
What is 2. The 27-year-old primigravida client who is complaining of blurred vision. Blurred vision is a symptom of preeclampsia, and this is the client’s first pregnancy. This client should be contacted first and told to come into the clinic for further evaluation.
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1. The client with severe lower abdominal cramping should be called to determine whether she is currently menstruating, but this is not priority over a pregnant client with symptoms of pre-eclampsia.
3. The expulsion of dark red blood clots indicates the client is going through menopause. This is not a life-threatening situation because dark red blood does not indicate frank bleeding.
4. This is uncomfortable for the client and indicates the need for a hysterectomy or instructions in the insertion and use of a pessary device to hold the uterus in place, but it is not life threatening.
The new graduate on a surgical unit does not take breaks or go to lunch and still cannot complete the work in a timely manner. Which statement is the preceptor’s best recommendation to the new graduate?
1. Suggest the new graduate look for a different position.
2. Start administering medications 2 hours early.
3. Clock out at the end of the shift and then finish the charting.
4. Do not skip the allowed breaks except during an emergency.
What is 4. Do not skip the allowed breaks except during an emergency. This is an appropriate suggestion to give to a new nurse. The nurse is having difficulty staying up with the tasks, and this can be overwhelming. If the nurse takes a break from the tasks, his or her mind will have a chance to rethink the tasks and set priorities.
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1. The preceptor is not being supportive by suggesting the nurse go elsewhere to work. 2. Starting medication administration 2 hours early is not in the acceptable guidelines for medication administration. 3. Finishing charting after clocking out at the end of a shift is not in accordance with wage and hour laws.
Which nursing diagnosis is appropriate for a patient receiving famotidine?
A. Risk for infection related to immunosuppression
B. Risk for injury related to thrombocytopenia
C. Impaired urinary elimination related to retention
D. Ineffective peripheral tissue perfusion related to hypertension
What is B. Risk for injury related to thrombocytopenia A serious side effect of famotidine is thrombocytopenia, which is manifested by a decrease in platelet count and an increased risk of bleeding. The patient receiving famotidine may experience hypotension as an adverse effect, not hypertension. Famotidine does not cause immunosuppression or urinary retention.
Common causes of conflict are (select ALL that apply):
A. Ineffective communication
B. Unclear expectations of team members in their various roles
C. Poorly defined or actualized organizational structure
D. Conflicts of interest and variance in standards
E. Incompatibility of individuals
F. Management or staffing changes
G. Diversity related to age, gender, race, or ethnicity
What is: ALL choices are correct :) A,B,C,D,E,F,G
The nurse on a pediatric unit has received the A.M. shift report and tells the UAP to keep the 2-year-old child NPO for a procedure. At 0830, the nurse observes the mother feeding the child. Which action should the nurse implement first?
1. Determine what the UAP did not understand about the instruction.
2. Tell the HCP that the UAP did not follow the nurse’s direction.
3. Ask the mother why she was feeding her child if the child was NPO.
4. Notify the dietary department to hold the child’s meal trays.
What is 1. Determine what the UAP did not understand about the instruction. Communication to the UAP must be clear, concise, correct, and complete. The nurse must determine why there was a lack of communication, which resulted in the child’s receiving food; therefore, this action should be implemented first.
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2. The nurse retains ultimate accountability for any delegated tasks and cannot blame the UAP for the child’s being fed by the mother. The HCP needs to be notified to cancel the procedure.
3. The nurse should talk to the mother about why the child was being fed, but the nurse must first determine whether the UAP told the mother not to feed the child and that the child was to be given nothing by mouth.
4. This action is too late to take care of the situation.
The client who delivered twins 3 days ago calls the women’s health clinic and tells the nurse, “I am having hip pain that makes it difficult for me to walk.” Which statement is the nurse’s best response?
1. “I am going to make you an appointment to see the HCP today.”
2. “This often occurs a few days after delivery and will go away with time.”
3. “Are you performing the Kegel exercises 10 to 20 times a day?”
4. “The pain may decrease if you empty your bladder every 2 hours.”
What is 2. “This often occurs a few days after delivery and will go away with time.” During the first few days after delivery, levels of the hormone relaxin gradually subside, and the ligaments and cartilage of the pelvis return to their pre-pregnancy position. These changes cause hip and joint pain that interfere with ambulation. The mother should understand that the pain is temporary and does not indicate a problem.
Which data indicates therapy has been effective for the client diagnosed with bipolar disorder?
1. The client only has four episodes of mania in 6 months.
2. The client goes to work every day for 9 months.
3. The client wears a nightgown to the day room for therapy.
4. The client has had three motor vehicle accidents.
What is 2. The client goes to work every day for 9 months. The ability to hold a job for 9 months indicates the client is responding to therapy.
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1. Four episodes of mania in 6 months do not indicate therapy has been effective. 3. Wearing a nightgown to the day room does not indicate the client is responding to treatment. 4. Three motor vehicle accidents do not indicate the client is responding to treatment.
A nurse is completing an assessment of a client who has a gastric ulcer. Which of the following findings should the nurse expect? (Select all that apply.)
A. Client reports pain relieved by eating.
B. Client states that pain often occurs at night.
C. Client reports a sensation of bloating.
D. Client states that pain occurs 30 min to 1 hr after a meal.
E. Client experiences pain upon palpation of the epigastric region.
What is C, D, E C.
CORRECT: A client report of a bloating sensation is an expected finding. D. CORRECT: A client who has a gastric ulcer will often report pain 30 to 60 min after a meal. E. CORRECT: Pain in the epigastric region upon palpation is an expected finding.
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A. A client who has a duodenal ulcer will report that pain is relieved by eating.
B. Pain that rarely occurs at night is an expected finding.
The charge nurse notices that one of the staff takes frequent breaks, has unpredictable mood swings, and often volunteers to care for clients who require narcotics. Which priority action should the charge nurse implement regarding this employee?
1. Discuss the nurse’s actions with the unit manager.
2. Confront the nurse about the behavior.
3. Do not allow the nurse to take breaks alone.
4. Prepare an occurrence report on the employee.
What is 1. Discuss the nurse’s actions with the unit manager. Usually, the charge nurse should attempt to settle a conflict at the lowest level possible, in this case, confronting the nurse. However, the charge nurse does not have the authority to require a drug screen, which is the intervention needed in this situation. The nurse should notify the unit manager.
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2. The charge nurse does not have the authority to force the nurse to submit to a drug screening, which is what this behavior suggests. Therefore, the charge nurse should not confront the staff nurse. The nurse should notify the supervisor.
3. Nurses have the right to take breaks with or without their peers. The charge nurse cannot enforce this option.
4. An occurrence report is not used for this type of situation. This is a management or a peer review issue. The nurse can go through the manager or a peer review committee.
Which of the following Negotiation solutions are considered a "loose-loose" solution(s)? (Select all that apply)
1. Avoiding/Withdrawing
2. Smoothing
3. Competing/Coercing
4. Cooperating/ Accommodating
5. Compromising/Negotiating
6. Collaborating
What is 1 & 2
1. Avoiding/Withdrawing 2. Smoothing
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3. Competing/Coercing - win‑lose solution
4. Cooperating/ Accommodating - lose‑win solution
5. Compromising/Negotiating - win‑lose solution
6. Collaborating - win‑win solution
The client in labor is diagnosed with pregnancy-induced hypertension and has preeclampsia. Which interventions should the nurse implement? Select all that apply.
1. Monitor the intravenous (IV) magnesium sulfate.
2. Check the client’s telemetry monitor.
3. Assess the client’s deep tendon reflexes.
4. Administer furosemide (Lasix) intravenous push (IVP).
5. Notify the nursery when delivery is imminent or has occurred.
What is 1, 3, and 5 are correct. 1. Magnesium sulfate, a uterine relaxant, is the drug of choice to help prevent seizures. The medication relaxes smooth muscles and reduces vasoconstriction, thus promoting circulation to the vital organs of the mother and increasing placental circulation to the fetus. 3. The deep tendon reflexes are monitored to determine the effectiveness of the magnesium sulfate. 5. The nursery should be notified of the delivery so it will be prepared for the neonate. Because the client is in labor, the baby will be born within a reasonable time frame.
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2. The mother is not placed on telemetry, but continuous electronic fetal monitoring is required to identify fetal heart rate patterns that suggest fetal compromise.
4. After delivery, the mother will excrete large volumes of fluid, a sign of recovery from pre-eclampsia. However, the loop diuretic Lasix would not be given before delivery because it may lead to hypovolemia.
The client’s arterial blood gas (ABG) results are pH 7.34, PaCO2 50, HCO3 24, PaO2 87. Which intervention should the nurse implement first?
1. Have the client turn, cough, and deep breathe.
2. Place the client on oxygen via nasal cannula.
3. Check the client’s pulse oximeter reading.
4. Notify the HCP of the ABGs.
What is 1. Have the client turn, cough, and deep breathe. These blood gases indicate respiratory acidosis that could be caused by ineffective cough, with resulting air trapping. The nurse should encourage the client to turn, cough, and deep breathe. ............................................................
2. The PaO2 level is within normal limits, 80 to 100. Administering oxygen is not the first intervention.
3. The nurse knows the arterial blood gas oxygen level, which is an accurate test. The pulse oximeter only provides an approximate level. 4. This is not the first intervention. The nurse can intervene to treat the client before notifying the HCP.
Patient who has GERD should avoid which of the following (select all that apply):
A. Chocolate
B. Peppermint
C. Coffee
D. Red Wine
E. Blueberries
F. Onions
What is A. Chocolate, B. Peppermint, C. Coffee, D. Red Wine, F. Onions