A nurse manager is confronted by a staff nurse who states that an assignment is unfair. Which of the following responses should the nurse manager make?

"What part of this assignment makes you upset?"

"Let's discuss how this affects your performance improvement plan."

"Why are you talking to me instead of the charge nurse?"

"You are not the only one with a heavy assignment today."

Answer and Explanation

The Correct Answer is A

A. "What part of this assignment makes you upset?": This response encourages open communication, allowing the staff nurse to express specific concerns. It demonstrates active listening, validation of feelings, and promotes problem-solving in a professional and supportive manner.

B. "Let's discuss how this affects your performance improvement plan.": This response shifts the focus to evaluation or discipline rather than addressing the immediate concern. It may create defensiveness and does not validate the nurse’s feelings or allow for discussion of the assignment issue.

C. "Why are you talking to me instead of the charge nurse?": This response is dismissive and may discourage the staff nurse from voicing concerns in the future. It does not address the fairness of the assignment or explore potential solutions.

D. "You are not the only one with a heavy assignment today.": Comparing workloads minimizes the nurse’s concerns and can be perceived as unsupportive. It does not facilitate problem-solving or acknowledge the staff nurse’s feelings about the assignment.

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Correct Answer is B

Explanation

A. High Fowler's: High Fowler’s position can assist with respiratory effort and comfort, but it does not specifically optimize cardiac output in a pregnant client. Upright positioning alone may not relieve pressure from the gravid uterus on major vessels.

B. Left lateral: Placing the client in the left lateral position relieves pressure of the uterus on the inferior vena cava and aorta, enhancing venous return to the heart and improving cardiac output. This position is especially important in clients with cardiac disease to reduce the risk of supine hypotensive syndrome and optimize maternal and fetal circulation.

C. Standing: Standing does not provide support for venous return and can increase the workload on the heart, potentially exacerbating cardiac compromise. It is not recommended for prolonged periods in clients with cardiac disease during pregnancy.

D. Supine: Supine positioning can compress the inferior vena cava and aorta, reducing venous return and cardiac output. This can lead to hypotension and decreased perfusion to both the mother and fetus, making it unsafe for pregnant clients with cardiac disease.

A. The client's high-density lipoprotein level has increased. B. The client's frequency of incontinence has decreased, C. The client's HbA1c has decreased. D. The client's iron level has increased.

Correct Answer is C

Explanation

A. The client's high-density lipoprotein level has increased: While metformin can have minor effects on lipid metabolism, an increase in HDL is not the primary therapeutic goal or a direct measure of the medication’s effectiveness in managing type 2 diabetes.

B. The client's frequency of incontinence has decreased: Urinary incontinence is not a direct indicator of metformin effectiveness. Changes in incontinence may result from other conditions or medications and do not reflect glycemic control.

C. The client's HbA1c has decreased: A decrease in HbA1c indicates improved long-term blood glucose control, which is the primary goal of metformin therapy. Monitoring HbA1c over 2–3 months helps determine how effectively the medication is managing type 2 diabetes.

D. The client's iron level has increased: Iron levels are not affected by metformin and do not serve as a measure of its efficacy. Changes in iron would be related to dietary intake, absorption issues, or other medical conditions rather than glucose management.

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A nurse manager is confronted by a staff nurse who states that an assignment is unfair. Which of the following responses should the nurse manager make?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is at 32 weeks of gestation and has a history of cardiac disease. In which of the following positions should the nurse place the client to promote optimal cardiac output?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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