After months of heavy patient loads and staffing issues in the Emergency Department, a natural disaster brings in many seriously injured individuals. A staff nurse appears to neglect some injured patients and is rude to two older adults. Upon noting this behavior of the staff, which of the following should the nurse manager suspect?

Staff role ambiguity

Staff hardness

Burnout

Staff depression

Answer and Explanation

The Correct Answer is C

Choice A Reason:

Staff role ambiguity refers to a lack of clarity about job responsibilities and expectations. While role ambiguity can lead to stress and confusion, it is not typically associated with the specific behaviors described, such as neglecting patients and being rude. These behaviors are more indicative of emotional and physical exhaustion, which aligns with burnout.

Choice B Reason:

Staff hardness is not a recognized term in the context of healthcare or nursing. It appears to be a typographical error or a misunderstanding. Therefore, this option is not applicable to the scenario described.

Choice C Reason:

Burnout is a state of emotional, physical, and mental exhaustion caused by prolonged stress and overwork. It is characterized by feelings of cynicism, detachment from work, and a reduced sense of personal accomplishment. The nurse’s behavior of neglecting patients and being rude to older adults is consistent with the symptoms of burnout. Burnout can significantly impact the quality of care provided and the well-being of healthcare professionals. Recognizing and addressing burnout is crucial for maintaining a healthy and effective workforce.

Choice D Reason:

Staff depression involves persistent feelings of sadness, hopelessness, and a lack of interest in activities. While depression can affect job performance and interactions with patients, the specific behaviors described in the scenario—neglecting patients and being rude—are more directly associated with burnout. Depression may coexist with burnout, but the primary issue in this context appears to be burnout due to the prolonged stress and heavy workload.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Choice A Reason:

Ms. P’s lunch tray is expected to be ready in 30 minutes. Before delivering her meal, please review with her the instructions provided by the diabetes educator earlier this morning and assist her in understanding how to manage her carbohydrate intake. Once you’ve completed this, please report back to me. This scenario involves patient education, which is beyond the scope of practice for unlicensed assistive personnel (UAP). According to the American Nurses Association (ANA), tasks that require specialized knowledge, judgment, and skills should not be delegated to UAP. Therefore, this scenario does not demonstrate appropriate delegation.

Choice B Reason:

Mr. O requires aid to use the restroom. I recognize that you’re new and might feel uneasy about this task, but the most effective way to learn is by giving it a try independently. After you’ve completed the task, please inform me of the outcome. While assisting a patient to use the restroom is within the scope of practice for UAP, the RN’s approach in this scenario lacks proper supervision and support. Effective delegation involves providing clear instructions, ensuring the delegatee is competent, and offering necessary supervision. This scenario does not fully meet these criteria.

Choice C Reason:

Mr. P has just called, reporting dizziness. Please attend to him promptly, assess his pulse, and if you suspect hypoglycemia, provide apple juice and then check his blood sugar. Afterward, please report your findings to me. This scenario involves assessment and clinical judgment, which are responsibilities of licensed nurses. UAP should not be tasked with assessing patients or making clinical decisions, as these require professional nursing knowledge and skills. Therefore, this scenario does not demonstrate appropriate delegation.

Choice D Reason:

Ms. O in Room 17 has completed her shower and requires assistance to return to bed. Please assist her promptly and ensure you bring her cane before you help her walk. After you’ve aided her back to bed, please inform me so I can evaluate her condition. This scenario is the best example of appropriate delegation. Assisting a patient with mobility and ensuring their safety by providing a cane are tasks within the scope of practice for UAP. The RN provides clear instructions and follows up to evaluate the patient’s condition, demonstrating effective delegation.

A. Discussing a client’s surgical procedure with the case manager. B. Reporting laboratory findings to a member of the client’s family. C. Identifying the client by name when making a referral for home health services. D. Notifying the provider of physical examination findings.

Correct Answer is B

Explanation

Choice A Reason:

Discussing a client’s surgical procedure with the case manager. This action does not constitute a breach of patient confidentiality as long as the case manager is part of the healthcare team involved in the patient’s care. Sharing relevant information with team members is essential for coordinated and effective patient care.

Choice B Reason:

Reporting laboratory findings to a member of the client’s family. This action is a breach of patient confidentiality unless the patient has given explicit consent for their health information to be shared with that family member. Confidentiality laws, such as HIPAA in the United States, protect patient information and restrict its disclosure without proper authorization. Sharing sensitive health information without consent violates these laws and the patient’s right to privacy.

Choice C Reason:

Identifying the client by name when making a referral for home health services. This action is generally acceptable as long as the referral is made to a healthcare provider or service that will be involved in the patient’s care. Proper identification is necessary to ensure that the patient receives the appropriate services and care.

Choice D Reason:

Notifying the provider of physical examination findings. This action is part of standard medical practice and does not breach patient confidentiality. Communicating examination findings to the provider is essential for accurate diagnosis and treatment planning.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An RN is delegating a task to an unlicensed assistive personnel. Which of the following scenarios best demonstrates appropriate delegation?

Correct Answer is D

Explanation

A nurse is delivering a presentation on client confidentiality to a group of newly licensed nurses. Which of the following actions demonstrates a breach in patient confidentiality?

Correct Answer is B

Explanation

In your role as the head nurse responsible for choosing patient surveillance systems for your unit, one of your objectives is to prevent adverse events by deploying suitable technology. This specific objective acknowledges that:

The nurse manager needs to create a patient satisfaction survey. What is one of the crucial factors to consider when choosing a patient satisfaction tool?

To help nurse managers better manage their time, the chief nursing officer suggests that they:

A nurse manager is planning to request two new mechanical ventilators at a cost of approximately $50,000 each. This item would typically be included in which budget?

Nurses perform numerous tasks that demand skills, judgment, precise motor control, and other forms of expertise that are challenging to replicate using AI. One example of such a skill that is difficult to replicate is:

A staff nurse confronts a nurse manager expressing that she believes the manager’s scheduling decisions are unfair. Which of the following responses by the nurse manager exhibits assertiveness?

To develop an effective staffing budget, the nurse manager should:

Upon examining her monthly budget report, the nurse manager observes a shortfall, leading her to modify the staffing schedule. Which of the following pieces of information exemplifies a negative variance?