A nurse manager is developing a plan to discipline an employee who has been neglecting to perform assigned duties. Identify the sequence of steps the manager should follow when using the progressive discipline process if the employee's behavior continues. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

Discontinue the employee's working relationship with the facility.

Set up a meeting to provide a verbal warning about the employee's performance.

Give the employee a brief paid or unpaid suspension from employment.

Issue a written reprimand with a timeline for correction of behavior.

Answer and Explanation

The Correct Answer is B,D,C,A

Progressive discipline begins with a verbal warning to make the employee aware of performance concerns. If the behavior persists, the next step is a written reprimand outlining expectations and deadlines for improvement. Continued issues lead to a suspension, which serves as a final warning. If no improvement occurs, termination of employment is the final step.

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Correct Answer is C

Explanation

A. Increased glucose level: CSF glucose levels are typically normal in multiple sclerosis. An increase in glucose is more commonly associated with systemic hyperglycemia or specific infections, not demyelinating diseases like MS.

B. Decreased lactic acid level: A decreased lactic acid level is not a characteristic finding in multiple sclerosis. Lactic acid in CSF is more relevant in differentiating types of infections, such as bacterial versus viral meningitis.

C. Increased protein level: Elevated protein in the CSF is a common finding in multiple sclerosis, often due to increased immunoglobulin production and the presence of oligoclonal bands, reflecting immune system activity in the CNS.

D. Decreased WBC count: While a mild increase in WBC count may be seen in MS, a decreased WBC count is not typical or diagnostic of the disease. Leukocyte levels in CSF are usually normal or slightly elevated in MS.

A. Place a vibrating tuning fork on the top of the child's head. B. Measure the amount of time the child can hear the sound. C. Obtain a tympanogram reading prior to initiating the test. D. Hold a vibrating tuning fork 1 to 2 cm (0.4 to 0.8 in) from the child's ears.

Correct Answer is A

Explanation

A. Place a vibrating tuning fork on the top of the child's head: The Weber test involves placing a vibrating tuning fork on the midline of the skull (forehead or top of the head) to assess lateralization of sound. It helps differentiate between conductive and sensorineural hearing loss.

B. Measure the amount of time the child can hear the sound: Measuring the duration of sound perception is used in the Rinne test, not the Weber test. The Weber test focuses on comparing hearing between ears, not the time the sound is heard.

C. Obtain a tympanogram reading prior to initiating the test: Tympanometry evaluates middle ear function but is not required before performing the Weber test. The Weber test can be done independently as a quick bedside hearing screen.

D. Hold a vibrating tuning fork 1 to 2 cm (0.4 to 0.8 in) from the child's ears: This method is used in the Rinne test to compare air conduction and bone conduction. It is not part of the Weber test, which relies on bone conduction through skull placement.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory results from a cerebrospinal fluid test for a client who has multiple sclerosis. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A school nurse is using the Weber's test to check a child's hearing acuity. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is teaching a client who has a new prescription for metformin extended release tablets. Which of the following statements by the client indicates an understanding of the teaching?

A home health nurse is planning care for an older adult client who has vision loss and takes medications throughout the day. Which of the following actions should the nurse include in the plan?

A nurse is planning care for a client who is undergoing brachytherapy with a low-dose radiation implant for treatment of prostate cancer. Which of the following interventions should the nurse include in the client's plan of care?

A nurse is planning care for a group of clients. Which of the following clients should the nurse plan to see first?

A nurse is planning to administer packed RBCs to an older adult client who has a low hemoglobin level. Which of the following actions should the nurse plan to take?

A nurse is teaching a client who has a new prescription for sertraline to treat depression. For which of the following findings should the nurse instruct the client to monitor and report immediately as indicating serotonin syndrome?

A nurse is caring for a pediatric client admitted with IV fluids. The client has bluish-white spots on the buccal mucosa with no other symptoms evident. Which of the following diseases should the nurse suspect?

A case manager is making a referral to hospice for a client who has cancer and has decided to stop curative treatments. The case manager is upholding which of the following ethical principles?