A student nurse is assigned to a preceptor. The preceptor rolls the eyes every time the student asks Questions and speaks badly to others about the student. Others have spoken to the preceptor about the behavior, but it continues. A colleague overhears the preceptor saying to the student, "You newbies don't know anything.
What are they teaching you in nursing school? Do you think you really belong in nursing?" What action should the colleague take?
Speak to the preceptor about the behavior.
Speak to the manager about the preceptor's behavior.
Tell the student to toughen up and speak to the preceptor.
Tell the student to request another preceptor.
The Correct Answer is B
Choice A rationale
While direct communication is often the first step in conflict resolution, this scenario describes a pattern of behavior that has already been addressed by others without success. The preceptor's behavior has escalated to verbal abuse and lateral violence. Simply speaking to the preceptor again is unlikely to change the behavior, as the individual has already demonstrated a lack of professional accountability. The situation requires formal intervention to protect the student and maintain a safe learning environment.
Choice B rationale
The colleague must report this behavior to the manager because it constitutes lateral violence and creates a hostile work environment. Professional standards and hospital policies typically mandate reporting of such conduct to ensure the safety of students and staff. The manager has the authority to investigate, provide formal counseling, or change the student's assignment. Addressing this at a management level ensures that the behavior is documented and that systemic steps are taken to uphold professional nursing standards.
Choice C rationale
Telling the student to "touhen up" is an inappropriate response that minimizes the impact of bullying and lateral violence. This approach places the burden of resolving a professional misconduct issue on the victim, who is in a vulnerable learning position. Such advice perpetuates a toxic culture in nursing where new members are expected to endure mistreatment. It fails to address the preceptor's unprofessionalism and does nothing to stop the cycle of abuse or ensure patient safety.
Choice D rationale
Suggesting the student request a new preceptor addresses the immediate problem for the student but fails to address the preceptor's underlying behavior. This "band-aid" fix allows the preceptor to continue mistreating future students or colleagues. While a new assignment may be necessary, it should be part of a formal process initiated by management. The colleague's responsibility is to report the unethical conduct through the proper chain of command to ensure long-term resolution and professional accountability.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Mucus production in the gastrointestinal tract is a physiological response to inflammation or irritation of the mucosal lining. While mucus might be present in various bowel conditions, including inflammatory bowel disease or certain infections, it is not the hallmark clinical indicator for an intestinal obstruction. Obstructions typically present with changes in stool shape, frequency, or complete cessation of passage due to the physical blockage within the lumen.
Choice B rationale
Ribbon-shaped stools are a classic clinical indicator of a partial intestinal obstruction, especially when caused by a mass or tumor. As the stool passes through a narrowed lumen created by the obstructing lesion, it is compressed into a thin, flat, or ribbon-like shape. This structural change in the stool provides significant diagnostic evidence of a reduced internal diameter within the colon or rectum requiring further medical investigation.
Choice C rationale
The odor of stool is primarily determined by the bacterial breakdown of proteins and the presence of specific compounds like skatole and indole. While a pungent or foul odor can occur with malabsorption syndromes, infections, or GI bleeds, it does not specifically indicate a mechanical intestinal obstruction. Odor is highly variable and influenced by diet and gut flora rather than the physical diameter of the intestinal passage.
Choice D rationale
Light brown stool is generally considered within the normal color range for human feces, resulting from the conversion of bilirubin into stercobilin. A change to light brown does not signal an obstruction. Significant color changes of concern would include acholic stools, which are clay-colored and indicate a lack of bile flow, or melena, which is black and tarry. Light brown remains a standard finding.
Correct Answer is B
Explanation
Choice A rationale
Anti-embolism stockings are designed to provide graduated compression to the lower extremities to promote venous return and prevent deep vein thrombosis. However, these stockings must be applied while the client is still in a recumbent position before they ever get out of bed. Applying them after the client has already stood up is ineffective because blood may have already pooled in the lower extremities, which increases the risk of clot formation and vascular strain.
Choice B rationale
Assisting the client to dangle their feet over the bedside allows the cardiovascular system to adjust to gravity after prolonged periods of horizontal bed rest. This prevents orthostatic hypotension, which is a drop in blood pressure that occurs when standing up too quickly. A normal blood pressure is typically around 120÷80 mmHg. By dangling, the nurse ensures the client does not experience dizziness or syncope, which could lead to a dangerous fall during the first ambulation.
Choice C rationale
Placing the client in a semi-Fowler's position involves elevating the head of the bed to an angle between 30 and 45 degrees. While this position is helpful for respiratory expansion and comfort, it does not sufficiently challenge the baroreceptor reflex needed for standing. It is a passive transition that does not provide the necessary step of dependent positioning for the legs. Therefore, it is an insufficient precautionary measure compared to the active step of dangling at the bedside.
Choice D rationale
Standing the client and immediately walking them to a chair is dangerous for a client who has been bedridden for three days. The sudden transition from lying down to standing can cause a rapid decrease in cerebral perfusion. The nurse must first evaluate the client's tolerance and stability while they are still supported by the bed. Moving directly to walking without a transition phase significantly increases the risk of injury for both the client and the nurse.
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